Glaucoma, often referred to as the “silent thief of sight,” is a progressive eye disease and a leading cause of irreversible blindness globally. It is characterized by an increase in intraocular pressure which, if uncontrolled, can damage the optic nerve, leading to vision loss and, in the most serious cases, blindness.
The peculiarity of glaucoma is its danger: in its initial stages, the disease manifests itself with few or no obvious symptoms. As it progresses, it can lead to peripheral vision loss, “tunnel vision,” and eventually total loss of vision. First-line therapy involves the use of eye drops that aim to reduce eye pressure, both by decreasing the production of aqueous humor and improving its drainage. But for many patients, consistently adhering to the therapy is tiring and they are not always able to perceive the advantage in terms of visual ability. In fact, the reader asks to know if there are other therapeutic options and if supplements can help. He replies Scipione RossiUOC director of Ocular Microsurgery at the San Carlo di Nancy Hospital in Rome.
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Request. I am 63 years old and have just received a diagnosis of glaucoma. My father also suffered from it but at a later age. Unfortunately, my eyes are already ‘tested’ because when I was young I underwent one of the first surgeries to correct myopia and I have several cuts on my left eye. The ophthalmologist prescribed me eye drops to put every night but he explained to me that this disease cannot be cured and this is very discouraging for me. Furthermore, over the course of the day my vision fluctuates, alternating moments (especially in the morning) in which I can see quite well even without glasses, to others in which I don’t see well despite the glasses. Is it possible that there are no other therapies apart from eye drops? I was also prescribed a supplement but I don’t really believe in the effectiveness of these products which among other things are very expensive. What do you think? I would like to preserve my visual ability as much as possible because it seems too early to lose autonomy: are there new treatment prospects?
Answer. The oscillation of your vision throughout the day is a symptom probably due to the fact that you underwent surgery for myopia with radial keratotomy cuts. This condition generates visual fluctuation throughout the day and unfortunately cannot be cured in any way with drugs. As for a possible alternative therapy to eye drops, a special laser has been available for some time that performs selective trabeculoplasty to lower eye pressure just like drops do. Thanks to this laser (which is repeatable over time) it is possible to avoid instilling the drops for a period varying from 1 year to 5 years. It is a treatment that has been carried out for some time but which recently, thanks to improvements in technology, is proposed in many cases as a first-line therapy for glaucoma as an alternative to the use of evening monotherapy as prescribed. This could be a good alternative to not instill eye drops and still have adequate eye pressure. It is clear, however, that the choice must be evaluated by your ophthalmologist who knows the conditions of your eyes in depth. As far as supplements are concerned, I cannot but deny any therapeutic action related to glaucomatous pathology.
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