The vision is responsible for 90% of our communication to the exterior world, being extremely important in the formation of one’s interior formation. It is for this reason the fear of blindness is supplanted only for the fear of having an untreatable cancer. However, on United States of America, 30% of patients stop using medication three months after diagnosed with glaucoma, and almost 70% of the rest forget to use the eye drops in the correct hour or don’t remember to use them once or twice.
It is important to know the loss of vision caused by glaucoma can never be recovered, besides all of the scientific knowledge currently available. Recently (2014), at the United States, at the Mayo Clinic, a study was presented showing 15% of the patients treated for glaucoma go blind, in six years, of at least one eye.
Around the world, there are approximately 11 million blind in both eyes and 20 million blind in one eye due to glaucoma. According to WHO, every year, there are records of 2,4 million new cases in the world. Although, thanks to the knowledge acquired in the last few years, blindness from glaucoma is avoidable in the majority of cases – if not all -, as long as diagnosed early and treated properly.
Prof. Remo Susanna Jr., Titular of the Ophthalmology Department of the Medical School of USP explains “to avoid blindness caused by glaucoma, it is necessary to know the most frequent reasons that, isolated or jointly, are responsible for almost every case of eyesight loss due to the disease”. The doctor emphasizes with this knowledge, patients are going to be able to interact in a more efficient way with their doctors and to establish an indispensable partnership with them for the control of the glaucoma.
The glaucoma occurs in 2% of white patients and 7% of black patients over 40, attacking 3,5% of white patients and 12% of black patients over their 70’s. With the increase of life expectancy of world population, these numbers will be even higher in the near future. “It is estimated people with a familiar history of the disease have among six to ten time higher the chances of developing it”, informs Prof. Remo Susanna Jr., member of the executive council and former president of the World Glaucoma Association.
The glaucoma is known as a synonym for high pressure in the eye. The FMUSP professor alerts “this wrongful concept persists to this day, being one of the main causes of undiagnosed and improper treatment of the disease. Besides, assuming this incorrect premise, the patient is led to believe, if their ocular pressure is normal, the disease is controlled”.
Prof. Remo Susanna Jr. explains “the glaucoma is characterized by an injury in the optic nerve, accompanied or not by an elevated ocular pressure and defect on the visual field. Therefore, the ocular pressure is considered the highest risk factor of glaucoma, but it can’t be understood as a synonym of the disease”.
According to the professor, the isolated measure of the ocular pressure, as it is usually taken, is extremely faulty to estimate the pressure variations the patient presents during the day. “Added to this is the fact people don’t come looking for ophthalmologists, mainly after their 40’s, when the disease is more common because they don’t struggle to see. The glaucoma is asymptomatic until its most advanced phases and, therefore, only the ophthalmologist can detect it”, emphasizes the doctor.
The inadequate or suboptimum control of the disease could lead to the progression of it, and, the more advanced the glaucoma, lower the target pressure needs to be for the control and higher will be the chances of the patient losing eyesight. The severity of the disease will also determine the frequency of consults and its intervals. In some cases, surgical intervention is needed to obtain compatible pressure with the severity of the glaucoma.
Recently, Prof. Remo Susanna Jr., has published two articles which obtained a high impact in the scientific community. The first one in partnership with professors Robert Ritch, director of the New York University (NYU), Jack Cioffi, director of the Columbia University, and Gustavo de Moraes, research director and associate professor at the Columbia University, also in New York. The second one, one of the 20 most downloaded articles in the papers in the last 20 years, was written in partnership with Prof. Ivan Goldberg, of the Sidney University, in Australia.
This research line developed by USP was also of great importance to the worldwide scientific community, resulting in more than 60 published works by different authors around the world and four editorials in impact journals. Thus, the knowledge of the ophthalmology discipline was promoted in several of its subspecialties.
For the carriers of glaucoma, this research line, identifying the peak pressure (the most elevated ocular pressure during the day), as the most important risk factor for the progression of the disease and a simple way of estimating it, through hydric overload, is of great importance “because it allows the control of the most important factor in the progression of the disease, unidentified up until recently, which can avoid the progression of the glaucoma or substantially reduce its progression speed”, highlights Prof. Remo Susanna Jr.