Glaucoma with normal intraocular pressure
In most cases a diagnosis of glaucoma is established when the intraocular pressure (IOP) rises above 21 mmHg. However, there are cases where this does not happen, but the IOP is maintained at normal levels.
This situation occurs mainly in people, as they grow older, and who may suffer different complaints capable of damaging the optic nerve without increasing IOP.
It may be because the passage of blood to the eye is obstructed, as with diabetes, arterial hypertension, hypotension, heart failure, etc., or because, with adequate blood circulation, not enough oxygen reaches the tissues of the eye. Eye as a result of a disease that is present with respiratory failure.
Optic nerve damage can also occur due to neurological causes, such as severe migraines.
The etiological differences in relation to the rest of the glaucomas also means that the symptoms are different, central vision deteriorating with the appearance of blind spots or haemorrhaging occurring in the ocular disc.
Also, an ophthalmic examination can detect alterations in different structures in the anatomy of the eye, especially in the optic nerve.
Keep in mind that although the IOP is normal, with the optic nerve being damaged, it can be harmful to it and increase existing damage. For this reason, pharmacological action should be taken to reduce IOP.
Another part of the treatment will focus on identifying and adequately treating the complaint that is causing the optic nerve injury, with medication being changed in some cases.
Finally, although it is an aspect that is still under investigation, a neuroprotective treatment can be applied to protect the optic nerve from further damage, which can be done with medications used to control IOP. In spite of everything, in this type of glaucoma the surgery also has guidelines.
TREATMENT AND SURGERY
Pharmacological treatment to reduce IOP can slow the progression of the disease in some people, although in others it may continue to worsen.
Identifying the complaint that is causing it and treating it properly is essential for monitoring normal IOP glaucoma. But if this is not the case, then the treatment will be the same as for open-angle glaucoma, which includes filtration surgery.
Results of the operation
In many of the people in whom it is possible to reduce IOP by 30% the growth of the glaucoma can be slowed down.
In the others, diagnosis and treatment may be more or less complex, but generally good results are obtained, although the patient should undergo regular ophthalmological tests.