Treatment of Glaucoma Combined With Cataract

About the disease

Among the most dangerous eye diseases are glaucoma and cataracts. Glaucoma is a condition whereby the optic nerve is damaged by continuous pressure inside the eye (intraocular pressure). Failure to stabilize this pressure in time can result in permanent loss of sight. According to WebMD, glaucoma is very often inherited. It can also develop as a result of injury, a serious eye infection or due to problems with the circulation of blood and optical fluids in and around the eye.

A cataract is the clouding over of the lens of the eye, which results in gradual vision loss. This disease accounts for 50% of all cases of blindness. Recently, new cataract treatments have been introduced, which can significantly decrease the percentage of blindness due to cataracts. In the USA, only 5% of cataract cases result in blindness, while in South America and Africa this figure reaches 60%. This can be explained by better access to medical treatment in the USA and the availability of better treatment options. Cataracts usually develop due to age and are common in people over 65 years old. However, medical conditions such as diabetes, previous eye trauma or surgery can also lead to cataracts.

Glaucoma can lead to cataracts and vice versa. For example, a person who has undergone glaucoma surgery may later develop cataracts; a person who has cataracts may later suffer from glaucoma.

Symptoms

• Gradual loss of sight
• Blurred vision
• Pain in the eye
• Trouble looking at bright light
• Redness of the eyes
• Visual disturbances, such as the appearance of halos

Diagnosis

• During a general examination, the ophthalmologist will check the patient’s eye for redness or changes to the structure of the lens.
• The doctor will ask the patient if cataracts or glaucoma run in their family. The patient will also be asked if they have any other medical conditions, which could be causing vision problems.
• An visual acuity test, in which the patient is asked to read letters of various sizes off a board a few feet away, is useful in determining how well they can see.
• Tonometry – a procedure that measures intraocular pressure – can be useful in diagnosing glaucoma.
• Ophthalmoscopy is a useful procedure for diagnosing both cataracts and glaucoma. The pupils are dilated by means of eye drops, so that the doctor can examine the back of the patient’s eye.

Treatment

• People who have both glaucoma and cataracts are often recommended to undergo surgery to treat both conditions simultaneously.
• Microinvasive non-penetrating deep sclerectomy is a surgical procedure whereby part of the sclera is removed, in order to stabilize intraocular pressure.
• Ultrasound phacoemulsification is a surgical procedure that uses vibrations to clear the cloudiness of the lens, that was caused by the cataract.
• Laser treatment can also be useful in treating cataracts and glaucoma, thereby preventing vision loss.

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed