By Andrea Hargraves 
The President of the Brazilian Society of Glaucoma (SBG), Augusto Paranhos Jr., said: Today (26), National Glaucoma Day, it is imperative that you are aware of the disease, at the initial stage, it is not showing symptoms. . “If a patient is expected to develop symptoms to make a diagnosis, the likelihood of blindness is very high.” And the doctor warned against the necessity of visiting an ophthalmologist even without complaint, remembering that there are silent diseases like this.
In an interview with Brazil AgencyThere is a nerve that connects the eye to the brain, Paranhos Jr. “Every image that reaches the bottom of the eye, and it is light, is processed and converted into an electrical impulse that passes through the nerve cells of that nerve and connects to the brain. Glaucoma is the death of the cell that connects the eye to the brain.” According to the expert, this cell does not regenerate and when it dies, it occurs without causing inflammation, that is, it does not cause pain. Therefore, a person does not notice.
“Because there are so many cells, in the beginning, a group of cells practically ends up taking on the role of some of the missing cells. To complicate matters a bit, if there is more advanced glaucoma in one eye compared to the other, then when both eyes open, the brain simply cancels out the area they are in. Vision is weaker. ” This means that when there is a complaint of vision loss due to glaucoma, the patient has already lost a lot of nerves.
I do not mind
SBG Prime compared glaucoma with uterine cancer in women and prostate cancer in men. “If a woman waits for symptoms of uterine cancer to see a doctor, she will die of uterine cancer.” The same applies to men with prostate cancer. The ophthalmologist said that glaucoma is the same.
Due to the Covid-19 epidemic, ophthalmology was one of the specialties affected by the fact that the patient did not go to a medical consultation. The prevalence increases with age, although glaucoma is present in children and younger patients. The elderly patient was the most confined person at home and ended up not coming to the office to make a diagnosis. “Chronic diseases are left untreated, from cancer to eye diseases.”
The doctor stressed that in order to diagnose glaucoma, a complete examination is necessary, which means more than one eye examination. It is necessary to expand the pupil, to take the fundus of the eye, the visual field.
Risk factors
Baranhos Jr. reiterated that everyone should see an ophthalmologist. He highlighted, among the risk factors for glaucoma, black race. “Patients of African descent are more likely to have glaucoma than whites. Nobody knows the cause, it is an ethnic trend. Because high blood pressure is more severe in black patients, so does glaucoma. It’s susceptible to race.” The same is true for the eastern patient, who has more normal pressure glaucoma. Glaucoma is high blood pressure in the eye. In eastern people, normal pressure glaucoma predominates and chronic closed angle glaucoma, while in black race, primary open angle glaucoma predominates.
According to the expert, there are more than 30 types of glaucoma, each with its own risk factor. For primary open-angle glaucoma, the main factor is ocular hypertension, and the only way to treat it is by lowering this pressure. Family history is another important risk factor.
Those who have a father or brother who are blind due to glaucoma should see a doctor and undergo a comprehensive examination and accompany him. Whoever has a family history needs to go to an ophthalmologist regularly to check. Another risk factor is myopia, for open-angle glaucoma, and farsightedness, for closed-angle glaucoma.
Baranhos Jr. explained that once a diagnosis is made, treatment “does not improve the patient’s vision at all, because it works to stop the deterioration. Not treating means losing everything, and going blind. That means a lot.” The patient should not stop taking the drug. To determine whether or not the treatment is appropriate, he must make an assessment of how the eye is functioning, that is, the visual field, and measure some of the structures that have changed in glaucoma, namely, an optic nerve image and a tomography of the eye. He added that a patient with glaucoma should undergo good monitoring by an ophthalmologist to find out what is the best treatment approach, so that he does not progress quickly and end up losing his eyesight.
Treatments
In general, treatment with laser or eye drops begins, “The laser is great, but it only works with open angle glaucoma and does not work for everyone – only for 60% to 70% of patients, and practically, there is no risk.” Regarding eye drops, the doctor said he could control the disease. When the initial laser and eye drops are not sufficient for some patients, they must do some surgeries and be able to stop the process. Postponing surgery will have a heavy burden, as the disease will progress and the person will not return to its initial stage.
Paranhos Jr. reports that in the past year, due to the pandemic, tests and surgeries have plummeted. “What we are seeing now is that, every day, uncompensated patients arrive in offices, due to the lack of control of the epidemic. It is imperative that we explain to residents that the idea of seeing a doctor only when they have a complaint and their awareness of risk factors is a misconception. Whoever is blind from glaucoma is the one who is blind. He makes a late diagnosis, and whoever has poor eyesight, and the tests show that he has the disease in an advanced stage, the specialist said, “The impression that we have is the missed opportunities.”
The doctor said that the global incidence of glaucoma in people over the age of 50 is 2%, and it is 3.5% in blacks. The prevalence is between 2% and 4%. The World Health Organization (WHO) estimates that 65 million people suffer from glaucoma in the world.