Glaucoma is a chronic neurodegenerative eye disease that affects the optic nerve, which is the "cable" responsible for transmitting visual stimuli from the eye's retina to the brain, ultimately converting visual information into images. Damage to the optic nerve in glaucoma is progressive, irreversible, and in the majority of cases, is related to increased intraocular pressure.
The term "glaucoma" was first mentioned by Hippocrates and originates from the ancient Greek word "glaukos", which means the open blue/blue-green shade of the sky or the sea. Today, glaucoma is the second leading cause of blindness worldwide. Modern epidemiological studies have estimated that one in 40 adults over the age of 40 suffers from glaucoma. This translates to approximately 60 million glaucoma patients worldwide, of whom 8.4 million have been blinded by the disease. In Greece, the prevalence of the disease is around 5% in the population over the age of 60. Despite this high prevalence, 50% of those affected remain undiagnosed. In other words, one in two glaucoma patients is unaware of their condition, with significant implications for their vision and eye health. Notably, 40% of participants in one study did not even know what glaucoma was. Lack of awareness is perhaps the most significant risk factor and the greatest challenge in addressing the disease, especially considering that one in five Greeks has never visited an ophthalmologist, and only 51% of individuals over the age of 50 regularly see their eye doctor. It has been proven that not having an eye examination by an ophthalmologist at least once a year increases the relative risk of undiagnosed glaucoma by six times.
The most significant risk factors for glaucoma, aside from lack of awareness, include advanced age, a family history of the disease, extreme refractive errors (high myopia or hyperopia), a history of eye inflammation or trauma, the presence of a thin cornea, and increased intraocular pressure, which is the most significant risk factor. This is also why the majority of therapeutic efforts aim to reduce eye pressure. It's crucial to remember that glaucomatous damage is irreversible. Our therapeutic efforts mainly aim to halt or at least slow down the progression of the disease, preventing significant damage to the optic nerve and visual field loss.
The primary problem with the most common form of glaucoma, known as "chronic open-angle glaucoma," is the absence of symptoms, with symptoms only appearing when a significant portion of vision has already been lost. This justifies the term "silent blinder" for glaucoma. The eye does not hurt, and it is not easy to perceive visual field defects without the use of specialized medical examinations. Here, the role of the specialized ophthalmologist is crucial, as they can recognize even the earliest stages of the disease through a series of tests. History, biomicroscopy, pressure measurement, gonioscopy, fundoscopy, corneal thickness measurement, automated perimetry, and measurement of the thickness of the retinal nerve fiber layer are basic examinations that all individuals over 40 who are at risk for glaucoma should undergo. Glaucoma can be diagnosed with a series of simple and painless tests. Early diagnosis and appropriate treatment by an ophthalmologist are key to avoiding irreversible glaucomatous damage that can lead to blindness from glaucoma. Prevention policies, education, and awareness, as well as easy, fast, and dignified access of patients to modern and reliable healthcare services, are essential components of a modern Western society. Only in this way can we reduce the rates of undiagnosed glaucoma and improve the effectiveness of therapeutic intervention in those who already suffer from glaucoma.
