Glaucoma, or “silent thief of vision” is one of the most dangerous eye conditions, and one of the three most common causes of blindness in the world. The term “silent thief of vision” describes this eye condition the best: symptoms of glaucoma, including pain, are extremely rare and so many few of them can point to it.
Actually, this ocular neuropathy is caused by an increase in the intraocular pressure above its normal value of 21 mmHg. This then leads to an irrevocable damage of the optic nerve, vision impairment, and in the terminal phase to blindness. Increase in the intraocular pressure can develop either by an increase of the aqueous humor creation, or by decrease in the aqueous humor drainage.
Prof. dr Nikica Gabrić, dr med.
Mr sc. Bojan Kozomara dr med.
Ernesta Potkonjak, dr med.
Nebojša Đogatović, dr med.
Sanja Savičić, dr med.
Ana Aničić, dr med.
Miloš Milićević, dr med.
Vladimir Račić, dr med.
Borjana Solomun, dr med.
Dajana Abdulaj, dr med.
Tamara Bojanić Barić, dr med
Here you can find frequently asked questions by our patients. If there are things that we did not answered for you, please don’t hesitate to contact us.
Even today, there are no exact facts on how glaucoma develops. It is not even still considered as a disease, but rather as a group of symptoms with devastating outcomes. Up until now, it has only been proven that some subtypes of glaucoma have hereditary components, while others can develop as a consequence of frequent inflammation of the eye, long time usage of topical corticosteroids, as well as in some types of cataracts.
Appearance of glaucoma within the family does not necessarily mean the presence of hereditary component of glaucoma, but it is advisable for all descendants of the affected patients to have regular ophthalmology exams every year after the age of 25. Increase in the intraocular pressure can also be seen in patients with high myopia
Glaucoma is most often seen in older patients, particularly in all of those who are 50 years or older, and if there were no previous eye traumas, it is extremely rare in young people and teenagers. Furthermore, even very rarely, glaucoma can appear in the newborns.
Glaucoma was previously diagnosed in all patients that had an intraocular pressure of more than 21 mmHg after three consecutive measurements, as well as the visual field defects.
Today’s glaucoma diagnostics has evolved rapidly, and besides the intraocular pressure values and possible visual field defects, corneal pachimetry and optical coherence tomography (OCT) play a crucial role in early glaucoma detection. When all of these parameters are taken into consideration, with outmost certainty glaucoma can be diagnosed and proper therapy assigned to each and every patient.
Basis treatment regimen for glaucoma treatment is the intraocular pressure control. First line of treatment includes topical anti-glaucoma therapy for aqueous humor reduction (beta blockers, carboanhidraze inhibitors, etc.), or for increase of the aqueous humor outflow (prostaglandins).
Surgical glaucoma treatment is most often used recently, especially in those patients who are on the local topical therapy for many years, and where eye drops produce allergic reaction of the cornea, conjunctiva and the eyelids.
Throughout history, glaucoma surgeries were done rarely, mainly due to the high degree of complications. Sometimes, these surgeries led to the complete blindness, quicker than the disease itself.
Laser glaucoma surgery today offers a temporary solution for “cleaning” of trabecular meshwork through which the aqueous humor flows outside the eye. However, in majority of patients, and after a few months of treatment, the trabecular meshwork cloths again and the intraocular pressure raises. On the other hand, lasers can be more useful in patients with angular glaucoma, where Nd:YAG lasers are used to open another communication between posterior and anterior chambers on the iris for easier and faster aqueous humor outflow.
Ex-Press glaucoma shunt implantation is currently the most sophisticated, most effective, and the least invasive surgical procedure for glaucoma treatment. With Ex-Press glaucoma shunt, more than 95% of patients are therapy free and with good control of intraocular pressure. The procedure itself is simple, and it is done under topical or sub-tenon anesthesia. During surgery, the tube (shunt) is placed in the anterior chamber of the eye, with its end on the superior part of the conjunctiva, outside the eye. Full effect of the surgery is seen 2-3 days postoperatively, and with its size of less than a fingertip, it does not disturb normal eye function.