Diagnosis and Treatment

Awanish Kumar,Ashwin Kumar

Published 2020 in Diabetes

ABSTRACT

In Japan, the estimated prevalence of glaucoma in the population older than 40 years was 5.0%, and 70% of them were diagnosed as normal tension glaucoma. Therefore, glaucoma is not diagnosed by the value of intraocular pressure (IOP) but the characteristic appearance of ocular fundus and the visual field defect related to the fundus appearance. Recently, the function-selective visual field test and optical coherence tomography (OCT), which detects thinning of the retinal fiber layer and decrease of retinal ganglion cells sensitivity, have been developed, making it possible to detect earlier stages of glaucoma and to treat it earlier. Various eye drops, including fixed combinations, are commercially available. Various types of minimally invasive glaucoma surgery (MIGS) have been developed as well, and the indication for these procedures have become widespread. However, even though glaucoma is a multifactorial disease, there is no other therapy than the reduction of IOP as an evidence-based therapy. It is necessary to elucidate the mechanism of occurrence and progression of glaucoma and to develop better methods to treat it. The diagnosis and treatment of primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) are summarized.

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