«Glaucoma is among the most important disabling pathologies in the world as regards vision; chronic and progressive disease, can lead to irreversible damage to the optic nerve (responsible for transmitting visual information from the retina to the brain). Glaucoma is caused by an increase in the pressure inside the eye and, in limited cases, by a reduction in the blood supply to the optic nerve”. These are the words of Antonello Cau, ophthalmologist at San Giovanni di Dio, guest of an episode of “15 minutes with…”, the in-depth talk on the health of the Cagliari university hospital, in collaboration with the L’Unione Sarda group , conducted by the journalist Fabrizio Meloni, head of communication and external relations of the Aou.
At an early stage, there are no symptoms to warn the patient of increased blood pressure. “Later, when the optic nerve starts to get damaged,” explains Cau, “the lateral portions of the visual field begin to be lost. So it is not the central vision that is damaged first. This explains why the deficit is not perceived quickly by the patient, who begins to bump into objects, to have small accidents with the car and to read with difficulty, without however realizing that he is losing lateral portions of the visual field ».
It is essential for the population, but also for the work of the ophthalmologists themselves, to carry out periodic screenings. «During routine eye examinations», continues the specialist, «the pressure of the eye is measured – normal between 10 and 21 millimeters of mercury – taking into consideration the appearance of the optic nerve. If the specialist finds inadequate values, he will ask the patient to undergo additional tests to certify the possible diagnosis of glaucomatous pathology. The most advanced centers for the treatment of glaucoma in Sardinia are the university hospital of Cagliari, the Brotzu hospital of Cagliari and the university clinic of Sassari».
The first treatment for glaucoma is generally pharmacological and involves the use of hypotonizing eye drops, to be applied to the eye regularly over a 24-hour period to ensure that the pressure remains constant (it is important to carry out close checks) . Surgical therapy of glaucoma is considered when drugs are no longer sufficient to control the flow and drainage of the aqueous humor.
Based on the specific case, the ophthalmologist can opt for the use of laser or incisional surgery. Surgical therapy of glaucoma is implemented to lower intraocular hypertension or correct the other factors that are at the origin of the disease. The objective of the intervention is to stop the progression of the disease and to decrease the intraocular pressure, constituting an additional way for the outflow of the aqueous humor.
Luca Mirarchi
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