Glaucoma, the Silent Thief of Sight

Unidad de Oftalmología y Catarata launches an information and prevention campaign for World Glaucoma Day.

Santo Domingo, Dominican Republic. World Glaucoma Day is observed during March, especially on March 12. Represented by Dr. Mariel Warden and Dr. Servando Santana, Unidad de Oftalmología y Catarata emphasizes prevention and early detection of this eye disease, one of the world’s leading causes of irreversible blindness.

About glaucoma

Glaucoma damages the optic nerve and causes progressive vision loss. It occurs when retinal nerve cells die, affecting the connection between the eye and the brain. These changes can be observed where the optic nerve begins and in the surrounding nerve fibers. Without timely treatment, the disease can significantly reduce visual-field sensitivity and lead to visual disability or blindness.

Worldwide, glaucoma is the second leading cause of blindness after cataracts. World Health Organization estimates indicate that more than 111 million people will be living with the disease by 2040. In the Dominican Republic, approximately 4% of the population has glaucoma, making it a significant public health concern.

One of the main diagnostic challenges is the absence of symptoms during early stages. An estimated 50% of patients do not know they have glaucoma until they have advanced, irreversible vision loss. UOC therefore stresses the importance of regular ophthalmology examinations, especially for people with a family history of glaucoma, so the disease can be diagnosed early and vision preserved.

Risk factors

Major risk factors include high intraocular pressure, family history, low ocular perfusion pressure, Black, Asian or Latino ancestry, age 50 or older, high myopia and a thin cornea. High blood pressure, diabetes mellitus and systemic hypotension are also associated with increased risk.

Glaucoma is divided into three main types—open-angle, angle-closure and childhood glaucoma—each with specific subtypes. In open-angle glaucoma, increased resistance in the drainage system makes it difficult for aqueous humor to leave the eye. In angle-closure glaucoma, the drainage pathway is blocked or very narrow. In childhood glaucoma, anatomical changes prevent proper drainage of aqueous humor.

All these mechanisms increase intraocular pressure. Identifying the type of glaucoma is essential to selecting the right treatment.

Treatment

Glaucoma treatment focuses on lowering intraocular pressure, the only modifiable risk factor. Normal intraocular pressure is generally between 10 and 21 mmHg, but the disease can develop within this range depending on each person’s optic-nerve tolerance. Treatment must therefore be personalized according to glaucoma type, target pressure and patient response.

Glaucoma cannot be cured, but it can be controlled. Current options include topical and oral pressure-lowering medications, selective laser procedures, minimally invasive surgery, conventional glaucoma surgery and valve implants. A complete ophthalmology examination, together with tests such as visual field testing and optical coherence tomography, determines the type and severity of glaucoma and the most appropriate treatment.

Prevention

Unidad de Oftalmología y Catarata urges everyone to have an annual eye examination. Timely detection can save sight.

By Dr. Mariel Warden and Dr. Servando Santana

Unidad de Oftalmología y Catarata, Dominican Republic