Chronic glaucoma is a quite common disease (1-2% of the population in France), particularly among adults after the age of 40 years, but sometimes among children or young adults.
This is a serious disease of the vision, resulting in a slow destruction of the optic nerve fibers which deteriorates insidiously the visual field, with threat of blindness if untreated.
The exact causes of glaucoma are not yet fully known. There are certain genetic factors (the descendants of patients with glaucoma are more likely to develop it).
Among the risk factors, an increased pressure within the eye is by far the most frequent and most important.
Measure of the intraocular pressure and the visual field.
There are three ways to lower the intraocular pressure and prevent the deterioration of the optic nerve and progression to blindness: eye drops, laser and surgery.
In practice, the first treatment often consists of hypotonic eye drops. This treatment can prevent glaucoma worsening for most patients.
If this treatment is not sufficient (if the field of view continues to deteriorate), a treatment, either by laser or by surgery may be offered depending on the age and the severity of glaucoma.
If the surgery is necessary, it is performed mostly under local anesthesia in a sterile site with a microscope. A small opening in the sclera to lower the pressure is performed.
Inefficiency of a medical treatment.
Perforating or not perforating fistula.
Variable, a reoperation or adding a medical treatment might be necessary.