Glaucoma: the most effective dietary supplements

Glaucoma is a chronic eye disease characterized by an increase in intraocular pressure (IOP), leading to progressive damage to the optic nerve. This condition can cause loss of peripheral vision and, if left untreated, can lead to blindness. There are several forms of glaucoma, the most common being open-angle glaucoma and angle-closure glaucoma.

Mechanisms of Glaucoma

In glaucoma, intraocular pressure rises when the aqueous humor, the fluid that fills the anterior chamber of the eye, is not properly drained. This fluid is continuously produced by the ciliary processes and must be removed through the trabecular meshwork to maintain normal IOP. When there is an imbalance between the production and outflow of aqueous humor, the pressure inside the eye increases, which leads to compression of the optic nerve and irreversible damage. Open-angle glaucoma is generally due to a progressive degeneration of the trabecular meshwork, while angle-closure glaucoma results from a sudden blockage of the drainage angle. Optic nerve damage may be related to mechanical compression (mechanical theory) or to poor blood supply to the optic nerve head (ischemic theory).

Risk Factors

Several risk factors increase the likelihood of developing glaucoma: • Age: Risk increases after age 40, especially after age 60. • Family history: People with close relatives who have glaucoma are at higher risk. • Ethnicity: People of African, Asian, and Hispanic descent are at higher risk. • Systemic diseases: Diabetes, hypertension, and cardiovascular disease can promote the development of glaucoma. • Myopia: People with myopia are more likely to develop open-angle glaucoma. • Corticosteroids: Prolonged use of corticosteroids, especially as eye drops, can increase intraocular pressure.

Classification and Symptoms

Glaucoma can be mainly classified into two types: Open-angle glaucoma This is the most common form, accounting for about 90% of cases. This type of glaucoma develops slowly and often without symptoms for many years. Clinical signs are subtle at first, making diagnosis difficult without regular screening. Elevated IOP leads to a gradual loss of peripheral vision (scotomas). In advanced stages, central vision may also be affected, and patients may develop irreversible blindness if not treated in time. Angle-closure glaucoma Less common, this type of glaucoma occurs when the drainage angle of the aqueous humor is suddenly blocked, causing a rapid rise in IOP. Unlike open-angle glaucoma, the symptoms are more acute: severe eye pain, headache, blurred vision, nausea, vomiting, and perception of halos around lights. Angle-closure glaucoma is a medical emergency requiring immediate management to prevent irreversible optic nerve damage.

Treatment

The goal of glaucoma treatment is to lower intraocular pressure to prevent damage to the optic nerve. Several options are available depending on the type and severity of the glaucoma: • Medications: Hypotensive eye drops are prescribed to reduce the production of aqueous humor or facilitate its outflow. These treatments include beta-blockers, carbonic anhydrase inhibitors, and prostaglandin analogs. • Laser: Laser procedures such as trabeculoplasty can be used to improve aqueous outflow in open-angle glaucoma. For angle-closure glaucoma, a peripheral iridotomy can be performed to restore fluid drainage. • Surgery: When medical or laser treatments are insufficient, surgical procedures such as trabeculectomy or the implantation of drainage devices may be necessary to control IOP.

Prevention

Early screening is essential to prevent the progression of glaucoma. A comprehensive eye exam is recommended every 2 to 3 years after age 40, or more frequently if risk factors are present. Monitoring IOP, controlling cardiovascular risk factors, and wearing protective eyewear when engaging in risky activities are important preventive measures.