You do not feel any pain, you have no visual impairment. And yet you may be suffering from glaucoma.
Glaucoma From the quarantine period, glaucoma should be systematically screened. 200,000 French would thus avoid the white cane. This severe disease of vision, which is accompanied in general by too high a pressure of the eye, causes a slow destruction of the optic nerve, which may lead to total loss of vision. More than one million people would be affected in France.
The primary causes of glaucoma are often unknown, but a number of risk factors have been identified: age, heredity, severe myopia, ocular traumatic history, arterial hypertension.
There are two types of glaucoma.
Open-angle glaucoma accounts for 90% of glaucoma cases in France. It is not accompanied by any particular pain or sign. It is impossible to know whether one is suffering from glaucoma beginning on the only signs that one can observe by oneself. Only an examination with an ophthalmologist can detect an early form of this disease and act when there is still time.
Each person is a special case. The treatment is, therefore, personalized. There is no standard treatment. Eye drops are the most prescribed drugs. Their use is often effective but the local administration of drops must be daily and often for life. In a case of failure, surgery should be undertaken. This is a very benign operation.
Unlike the first, and much rarer, closed angle glaucoma does not go unnoticed. It manifests itself in the sudden appearance of a dull and persistent pain, associated with nausea and impaired vision. It is a medical emergency, requiring immediate intervention.
Finally, be aware that, contrary to popular belief, glaucoma is not improved by a specific diet, and that reading or watching a computer does not make it worse.
Glaucoma: Early essential screening
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Glaucoma
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- Glaucoma: an insidious disease
- Glaucoma: Early essential screening
- Glaucoma: better understanding intraocular pressure
- Glaucoma: zoom on current treatments
- Diagnosis of glaucoma: at age 40, consult your ophthalmic every 2-3 years
- Disease of the eyes, glaucoma can lead to blindness. However, this progressive and insidious condition can remain asymptomatic for 20 years! Only early screening as early as age 40 and continuous treatment allow good management of the disease.
Today, an estimated 650,000 people are treated for glaucoma, but 400,000 people are unknowingly infected.
glaucoma: an insidious disease
Early Detection of Glaucoma There is several forms of glaucoma, including chronic open-angle glaucoma, which is most often painless, 2 and acute closed-angle glaucoma, which is rarer but causes severe pain. "In the case of chronic glaucoma, which affects 2% of the French population over 40 years of age, 3 the condition is established without making noise, but it is absolutely necessary to take care of it, since it is the second cause of blindness in Developed countries, "explains Professor Jean-Paul Renard Head of the Ophthalmology Department at the Val de Grâce Hospital in Paris.
glaucoma: Act Before the First Symptoms
If you experience symptoms (one of your eyes sees poorly or a fraction of your visual field has disappeared) is that the disease has been established for a long time already. Consequences: Treatment is often less effective than when administered at an early stage. Furthermore, in the absence of treatment, glaucoma evolves towards the loss of vision. Early diagnosis by an ophthalmologist is strongly recommended.
Treat glaucoma at the earliest
Since the condition remains silent for a long time, the only way to diagnose it and of course treat it is to make an appointment with an eye specialist. If you do not have specific risk factors, you should consult every two years from the age of 40.
Glaucoma is screened using a number of examinations such as visual field, intraocular pressure, or the fundus of the eye to analyze the condition of the optic nerve.
Risk factors and diet: new perspectives
Everyone is not equal to this eye condition that causes irreversible damage to the optic nerve 4. Thus, people over the age of 40, those with elevated introduced- tory pressure (IOP) or myopia, A family history of glaucoma or black-skinned populations are more exposed to the risk of open-angle glaucoma. In addition, high blood pressure, hypercholesterolemia, and diabetes are potential risk factors.
Currently, the research is attempting to identify more precisely patients with risk factors. The objective is to take care of the disease at an earlier stage in order to delay the development of visual deficits.
Written by:
Delphine Bourdet
Created on March 18, 2010
Sources:
1 - DGS / GENDO. Vision Disorders (available online)
2 - European Glaucoma Society. Guide for glaucoma 2003. 2nd edition. Editions Dogma, Savona, Italy. Www.eugs.org: ch.2-15,16
3 - HAS -High Health Authority -Recommendations in Public Health -Report. Early diagnosis and diagnosis of glaucoma: issues and prospects in France November 2006
4 - Béchetoille A. The Glaucomas. Ed. Japperenard. 1997. vol 1: p.222; P.416
Glaucoma: better understanding intraocular pressure
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Glaucoma
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Glaucoma: an insidious disease
Glaucoma: Early essential screening
Glaucoma: better understanding intraocular pressure
Glaucoma: zoom on current treatments
Diagnosis of glaucoma: at age 40, consult your ophthalmic every 2-3 years
In most cases, glaucoma, a disease of the optic nerve, is linked to a high intraocular pressure. However, all ocular hypertonias do not evolve systematically towards the progressive loss of the sight ... The point to see more clearly!
Do you have high intraocular pressure (IOP)? Difficult to answer this question without ophthalmological examination since no symptom indicates ocular hypertonia. However, this fact is important to prevent a possible progression to glaucoma, a condition that can reduce the visual field to blindness.
Intraocular pressure in brief
Intraocular pressure The stability of the intraocular pressure is ensured by the balance between the production of a transparent liquid called "aqueous humor" (which brings the necessary nutrients to the iris, the lens, and the cornea) and its evacuation outside The eye through a filter, which is called the trabeculae.
A lack of evacuation of the aqueous humor leads to an increase in the intraocular pressure. "Intraocular pressure (IOP) expressed in millimeters of mercury (mmHg) is on average 15.5 (+/- 2.5) mmHg 1. An IOP is considered abnormal when it exceeds 21 mmHg", explains Professor Jean-Paul Renard, Head of the Ophthalmology Department at the Val de Grâce Hospital in Paris.
Glaucoma and IOP: an obvious link
When the pressure is too high, the back of the eye can be compressed, which then destroys the fibers of the optic nerve. "People with ocular hypertonia should be followed because having an intraocular pressure greater than 21mmHg is the first risk factor for developing glaucoma," says Professor Jean-Paul Renard.
However, having high IOP is not a disease. Only 1/3 of people with ocular hypertension are at risk of developing glaucoma.
Monitor eye hypertension
To control your intraocular pressure, you just have to make an appointment with an ophthalmologist. The specialist will evaluate the pressure by means of a jet of painless air thrown by a device directly on the eye or an "explanation measurement" which consists (after instillation of anesthetic eye drops and a colored eye) to pose A device on the cornea by exerting a slight pressure on it.
If you discover that your IOP is greater than 21 mmHg, you will have to follow a regular follow-up with your ophthalmologist because it is better to see glaucoma coming than not to see anything at all!
glaucoma: zoom on current treatments
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Glaucoma
SEE AS WELL
Glaucoma: an insidious disease
Glaucoma: Early essential screening
Glaucoma: better understanding intraocular pressure
Glaucoma: zoom on current treatments
Diagnosis of glaucoma: at age 40, consult your ophthalmic every 2-3 years
Irreversible involvement of the optic nerve, glaucoma causes a progressive loss of visual field. If the treatments do not allow the cure, they delay the development of the disease ... provided they take seriously!
Following a first medication prescription to treat glaucoma, 20 to 27% of patients do not resume appointment with their ophthalmologist. "Most patients are unaware of the dangers of this disease, and they do not feel any particular gene, so they do not see the benefit of regular treatment," explains Professor Jean-Paul Renard, Ophthalmology at the Val de Grâce Hospital in Paris. However, untreated glaucoma leads to partial or complete loss of vision. Glaucoma treatment
Objective: stabilize the view
Thanks to the advancement and complementarity of the treatments (medication, laser, surgery), these last considerably delay the degradation of the site 1. "The sooner the diagnosed glaucoma is diagnosed, the more efficient the treatment will be. Of an early screening 2 ", emphasizes Professor Jean-Paul Renard. Thus, it is possible to stabilize vision in 80% of the cases of rapidly supported glaucoma.
Treatment of glaucoma: more effective eye drops
With the arrival of new molecules on the market, including prostaglandin, drug treatments are easier to take. Thus, instead of having two to three eye drops per day, patients can now reduce their intraocular pressure by administering one to two eye drops once a day.
Trabeculoplasty with laser
If it is common to treat glaucoma medically, laser operations are not performed systematically. The practice of the laser depends on the clinical form of glaucoma, the course of the disease, its stage ... The objective of trabeculoplasty is to lower the intraocular pressure by allowing the aqueous humor to flow more easily.
Surgery, a complementary act
As with the laser, the decision to operate must be made according to each patient and reduces the intraocular pressure without guaranteeing any positive effects in the long term.
"The operation is not straightforward because if the results are good, they are not 100%. Often drug treatment must be resumed a few months after surgery," says Professor Jean-Paul Renard.
Whatever the form of treatment, it is essential to follow it rigorously because if "the essential is invisible to the eyes", the progress of research now allows patients to see the future more serenely!
Omega 3 to prevent glaucoma?
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Omega 3 for seniors
Glaucoma
Gathered at the congress of the French Society of Ophthalmology, the experts examined the risk factors for the onset of glaucoma. For the first time, protective foods have been identified against this disease: nuts and fatty fish. Essential sources of Omega 3.
As a result of optic nerve damage, glaucoma leads very gradually to narrowing of the visual field. If left untreated, it evolves into blindness. The most common glaucoma, known as open-angle primary glaucoma, does not cause symptoms for many years (10 to 20 years). Without pain or special discomfort, it can only be diagnosed during this long period by an examination in the ophthalmologist. When vision problems arise, many optical fibers have already been destroyed. Faced with this silent disease, prevention is therefore particularly useful: hence the interest in knowing more about protective factors, easy to exploit when it comes to the content of the plate.
Omega 3, candidates for the prevention of glaucoma ...
Omega-3-prevention-glaucoma Combining ophthalmologists, epidemiologists, and nutritionists, the PhotoGRAF1 study analyzed very finely the nutrition of 678 volunteers, half suffering from glaucoma, the other half having high intraocular pressure but No glaucoma. Both groups had the same characteristics (age, gender, etc.) to facilitate comparison. Results: people consuming less than 8 times a year of nuts, or less than once a week of fatty fish (herring, mackerel, sardines, salmon ...) were twice as likely to develop glaucoma.
These foods share excellent intakes of omega-3, alpha-linolenic acid (the precursor of all omega-3s in the body) for nuts, eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) for fatty fish. "Nothing surprising about this," commented Pr Renard, head of the ophthalmology department at the Parisian Val de Grace hospital and coordinator of the PhotoGRAF study, "we know that these compounds have an important role in the nervous system And potential prevention of neurological diseases, but so far we have very little data on their interest in optic nerve diseases. " Indeed, DHA is the most concentrated fatty acid in the membranes of neurons, and retinal cells whose fibers constitute the optic nerve2.
What dose should be taken off omega 3 to protect against glaucoma? The PhotoGRAF study suggests that the recommended intake is sufficient: to have an ALA quota, two tablespoons of walnut or grapeseed oil per day (equivalent to 10 nuts) and two fish Fat per week. However, says Renard, "Further work is needed to specify an effective minimum dosage. Note that a new anti-glaucoma drug (oral) with omega-3 is currently being studied.
Special attention should be paid to exposed persons
By targeting as many factors as possible to reduce or increase the risk of glaucoma, the PhotoGRAF study aims at early management of those most at risk. Three risk factors dominate:
High intraocular pressure, which causes compression of the optic nerve;
Family history in 50% of cases;
The advanced age, which is accompanied by an irreversible loss of optical fibers (the nerve cells are not renewed): at age 40, 0.5% of the population is concerned, after age 65, it is 5 % 3.
The ethnic group also counts: there are more glaucomas in the black populations.
There are ocular risk factors such as myopia. Other risk factors are related to diet, such as hypercholesterolemia, and fluctuating blood pressure. The consumption of coffee and/or tobacco occasionally increases intraocular pressure. Finally, the PhotoGRAF study showed for the first time the deleterious effect of the pesticides in their manipulators (the farmers). "Not surprisingly, pesticides are known as neurotoxic agents".
Omega 3 and AMD: Known Links
Another serious eye disease, age-related macular degeneration (AMD) affects 10% of the population at age 45, but 50% at age 85. This involvement of the macula, the area of the retina most exposed to light rays, would affect 1.25 million French.
"KAnother serious eye disease
, age-related macular degeneration (AMD) affects 10% of the population at age 45, but 50% at age 85. This involvement of the macula, the area of the retina most exposed to light rays, would affect 1.25 million French.
Retina and optic nerve act as a network for good vision: the retina receives luminous images which it transforms into nerve information (phenomenon of phototransduction), the optic nerve transmits this nerve impulse to the brain in the visual recognition area.
"Knowledge of ocular functioning and pathophysiology is giving rise to a growing interest in omega-3s," explains Lionel Brétillon, a researcher in the Oeil et Nutrition team at the INRA in Dijon. Omega 3 is essential to the phototransduction phenomenon. Epidemiological studies have shown their value in preventing and slowing the progression of AMD. Specifically, protective foods would be fatty fish, especially when the intake of another essential omega 6 fats is not too high. "Our knowledge of the nutritional factors common to AMD and glaucoma is advancing and they need to be further explored, to ensure the best possible prevention of these two conditions," concludes Professor Renard.
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