France has around 1.2 million people suffering from glaucoma, that is to say degeneration of the optic nerve. A disease which, if not treated, “leads to a loss of visual acuity and gradually reduces the visual field”, underlines Professor Antoine Labbé, ophthalmologist at the Quinze-Vingts hospital in Paris, and secretary general of the French Ophthalmological Society. « Glaucoma is the second leading cause of blindness behind age-related macular degeneration. specifies the specialist.
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This disease is all the more pernicious as it develops slowly and silently in the vast majority of cases, without causing any symptoms or pain before it reaches an advanced stage. “Once it is discovered, it is impossible to recover what it has destroyed, warns Professor Labbé. It is therefore crucial to diagnose it as early as possible. »
Eye tension to monitor
To do this, certain risk factors must be taken into account. The first of these: increased eye tension. Be careful, however, it cannot, on its own, reveal the presence of the disease. “Some people do not have abnormal intraocular pressure but unknowingly develop glaucoma,” notes the specialist.
Another observation, eye pressure and high blood pressure are two completely independent phenomena. In other words, having high blood pressure does not increase the risk of suffering from glaucoma. Finally, other elements also promote glaucoma: family history, high myopia, age over 50, African or Afro-Caribbean ethnic origin, diabetes, sleep apnea, etc.
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When the age of forty approaches and the first signs of presbyopia begin to cause discomfort, a good reflex: consult an ophthalmologist every two years – every year in the event of a family history – to carry out a screening. The diagnosis is based on a range of arguments: measurement of eye tension, clinical examination of the optic nerve, optical coherence tomography to quantify the thickness of the fibers passing through the nerve, visual field to check whether, in what sees the patient, certain areas are affected or absent”,
summarizes Professor Labbé.
Effective treatments
When glaucoma is discovered, several treatments can be implemented, all of which aim to considerably slow down its progression. Their common point: they seek to lower intraocular pressure. “It is not possible to completely stop the degeneration of the optic nerve, notes Professor Labbé, but early treatment helps avoid the risk of blindness in 90 to 95% of patients. »
Several options are available to healthcare professionals, depending on the patient and the progress of their glaucoma, starting with traditional eye drops. In recent years, however, recommendations have called for the first-line use of laser trabeculoplasty, aimed at making the trabecular meshwork, a sort of filter of the eye which ensures the evacuation of aqueous humor, more permeable.
When eye drops and lasers remain insufficiently effective, it is surgery that we must finally turn to with the installation of a permanent drain. “Minimally invasive techniques are much safer and can be offered earlier than traditional surgery,” reassures Professor Labbé.
