Causes of blindness in the modern world and glaucoma as one of the leading causes

Sljepoća sa svojim socijalnim i ekonomskim posljedicama predstavlja teret svakom društvu. Etiologija sljepoće mijenjala se tijekom 20.stoljeća do danas. Sljepoća uzrokovana zaraznim bolestima oka danas je u padu, dok se među najčešće uzroke smatraju katarakta, glaukom i makularna degeneracija ovisna o dobi. Glaukom je bolest koju karakterizira optička neuropatija koja s vremenom dovodi do oštećenja vidne funkcije i nepovratnog gubitka vida. Klinički, glaukom se dijeli na primarni, sekundarni i kongenitalni. Primarni glaukom dijeli se na primarni glaukom otvorenog kuta (engl. Primary Open-angle Glaucoma (POAG) i primarni glaukom zatvorenog kuta (engl. Primary Angle-closure Glaucoma (PACG). POAG čini 90 % svih slučajeva glaukoma u zapadnom svijetu. Obilježen je progresivnim i asimptomatskim tijekom te čak 50 % bolesnika nije ni svjesno bolesti, dok u nerazvijenim zemljama ta brojka dostiže i 90%. Drugi je najčešći uzrok sljepoće diljem svijeta i predstavlja velik javnozdravstveni problem. Pravilna dijagnostika sastoji se od detaljno uzete anamneze, pregleda vidne oštrine, mjerenja očnog tlaka, određivanja vidnog polja, mjerenja debljine rožnice, pregleda očnog kuta i provjere oštećenja očnog živca pomoću optičke koherentne tomografije (OCT). Terapija glaukoma sastoji se od antiglaukomskih lijekova (adrenergički agonisti, adrenergički antagonisti, inhibitori karboanhidraze, parasimatikomimetici, derivati prostaglandina i prostamidi, kombinacija navedenih lijekova), terapije laserom (laserska iridotomija, laserska trabekuloplastika, laserska iridoplastika, ciklofotokoagulacija) i kirurške terapije.
Blindness with its social and economic consequences is a burden to any society. The etiology of blindness has changed during the 20th century to the present day. Blindness caused by infectious eye diseases is declining today while cataracts, glaucoma and age-dependent macular degeneration are among the most common causes. Glaucoma is a disease characterized by optic neuropathy that over time leads to impaired visual function and irreversible vision loss. Clinically, glaucoma is divided into primary, secondary and congenital. Primary glaucoma is divided into Primary Open-angle Glaucoma (POAG) and Primary Angle-closure Glaucoma (PACG). POAG accounts for 90% of all glaucoma cases in the Western world. It is characterized by a progressive and asymptomatic course, and as many as 50% of patients are not even aware of the disease, while in underdeveloped countries this number rises to 90%. It is the second most common cause of blindness worldwide and poses a major public health problem. Proper diagnosis consists of a detailed history, examination of visual acuity, measurement of intraocular pressure, determination of visual field, measurement of corneal thickness, examination of the ocular angle and examination of optic nerve damage using optical coherence tomography (OCT). Glaucoma therapy consists of antiglaucoma drugs (adrenergic agonists, adrenergic antagonists, carbonic anhydrase inhibitors, parasympathomimetics, prostaglandin derivatives and prostamides, a combination of these drugs), laser therapy (laser iridotomy, laser trabeculoplasty, cybeculoplasty, cybecolaguloplasty, laser trabeculoplasty).