Late diagnosis is a major cause of blindness in glaucoma, says Dr. Denis Slinkin. The main risk factor for glaucoma is an increase in intraocular pressure. Normally the intraocular pressure is 11-21 mm Hg, on average it is 15.5 mm Hg. Apparently, the risk of blindness is directly proportional to the degree and duration of the intraocular pressure increase.
However, up to 20% of patients with characteristic changes in the optic nerve and fields of vision have normal intraocular pressure. It seems that other factors, such as vascular spasm, contribute to the damage of the optic nerve in these patients.
Many factors influence the level of intraocular pressure. Intraocular pressure changes during the day and is often higher in the morning. These variations in intraocular pressure depend on individual daily rhythms and may vary greatly from person to person. Intraocular pressure rises slightly when a person lies on his back.
In hypertension, intraocular pressure increases only slightly, but it can be reduced by prescribing hypotensive drugs such as beta-adrenoblockers and calcium antagonists. There is no consensus on the effect of caffeine, smoking and exercise on intraocular pressure.
There is also a small group of individuals with a high sensitivity to glucocorticoids. Their intraocular pressure may increase significantly in response to systemic or local (in eye drops) glucocorticoid use.Occasionally, the application of creams or ointments containing glucocorticoids to the skin around the eyes also causes this reaction, says Dr. Denis Slinkin.
Dr. Denis Slinkin argues today that the role of heredity in the development of many types of glaucoma is clear, and any person with glaucoma in their immediate family (parents, siblings) should be placed at risk, especially after the age of 40. In addition, the risk of glaucoma is increased in diabetes mellitus, high myopia, arterial hypertension and cardiovascular diseases.