It is one of the most unknown ocular pathologies and, nevertheless, it is the second cause of blindness in the world. In Navarra more than 13,000 people could be affected. Glaucoma is the second cause of blindness and affects more than 61 million people worldwide, 7 million of whom have already lost their sight completely. In Spain, the issue number of people affected is close to one million; in Navarra, around 13,000. According to data of the World Glaucoma Association, it is expected that by 2020 the number of people affected worldwide by this pathology will be close to 80 million. Of these, two thirds will be women.

It is a silent disease in which the optic nerve is damaged without the patient hardly noticing any symptoms. This absence of symptoms is probably the main problem to fight against. For this reason, the main recommendation is to insist on early diagnosis with a test as simple as taking the eye pressure, which can prevent up to 95 percent of cases of vision loss. This week is World Glaucoma Week, organized by the World Glaucoma Association, with the slogan "Beat Invisible Glaucoma". On this occasion, conferences and other activities are being held to raise awareness of the importance of this disease.

Ignorance of what this disease can entail makes it even more dangerous, since when it progresses, the damage caused is irreversible and can lead to blindness. That is why glaucoma is called "the stealth thief of vision". No one will die of glaucoma, but it is still a serious health problem, because it is a chronic and incurable disease. Once the disease is diagnosed, medical or surgical treatment can almost completely stop the damage to the nerve, so the greatest danger of this disease is not knowing about it, not assessing it, or not having your eye pressure checked after the age of 40.
 

Elevated eye pressure can trigger a series of processes that result in accelerated nerve cell death. The optic nerve can be compared to a wire that transmits images from the eye to the brain. Inside a wire there are many copper filaments that transmit electricity. Therefore, measuring the issue of these "wires" or nerve cells of the optic nerve provides valuable information about the transmission of the peripheral field to the retina. It is as if the copper wires inside the cable were being cut without the cable being completely severed. When optic nerve damage appears, scotomas or areas with reduced or no vision are produced. Sometimes, the patient comes to the ophthalmologist because grade reduced vision, because his field of vision is no longer "what it was". I remember a patient who came to enquiry because, while playing tennis, he noticed that sometimes if the ball came from one side he could not see it coming.

Risk factors and new therapeutic alternatives
The risk factors for this pathology are high intraocular pressure, high myopia, age and family history. Nowadays we can also evaluate genetic markers that indicate the possible presence of glaucoma in a family, or the speed of progression of the disease.

However, there is also hopeful information, since today there are very advanced exploratory techniques capable of detecting the disease in very early stages, such as OCT. The earlier glaucoma is diagnosed and treated, the better the long-term prognosis deadline of the disease. There are also a wide variety of treatments that prevent nerve damage from progressing further and thus prevent further vision loss. The research and clinical trials currently underway have provided new drugs and surgical techniques that offer considerably more therapeutic alternatives.
At summary, the atrophy of the optic nerve caused by glaucoma is irreversible and, if left untreated, will lead to blindness. When the disease is diagnosed, many patients are overcome with a feeling of ignorance and helplessness. However, regular check-ups and following the prescribed medical treatment slows down the progression of the disease. The first thing to do is to have your intraocular pressure checked periodically and have ophthalmological check-ups after the age of 40 or earlier if you have any of the risk factors described above. Vision is important enough in every person's life to dedicate a little time to find out if something silent is stealing it.