Glaucoma / Ocular Hypertension

Ocular hypertension is the permanent or intermittent elevation of the pressure inside the eye above the normal range. It is not a disease in itself but it is a risk factor because it can lead to glaucoma and cause irreversible damage to vision. This type of hypertension is common and has no outward symptoms, so it is very important for it to be diagnosed. On the one hand, the patient must be checked regularly so that any sign of progression to glaucoma is detected immediately as at first it shows no symptoms but it can end by damaging vision irreversibly. On the other hand, according to current guidelines, some groups of patients with ocular hypertension should receive prophylactic treatment in order to prevent it from progressing to glaucoma.

Glaucoma is a complex disease of the optic nerve and some retinal layers and cells caused by an important, but not only, factor of risk, which is pressure inside the eye (intraocular pressure – “IOP”). It is so common that at present, despite huge advances made in its diagnosis and treatment, it is the leading cause of blindness in the developed world.

It is a disease that is often hidden and treacherous because it has no symptoms but, by the time a patient is aware that there is a problem, the irreversible loss of vision is very significant.

It is a chronic disease, sneaky and difficult to stop or slow down because treatments that work often stop working without prior symptoms or warning, and treatments that work for most patients tragically demonstrate that they do not help everyone.

Finally, treatment for glaucoma requires patients to be meticulous in following complex procedures that require the use of several different types of drops several times a day, which is why compliance is often poor.

So, while for a time there are no warning symptoms, this failure to comply with treatment can have very negative and irreversible consequences for the patient’s vision. Unlike cataracts, the surgical management of glaucoma is more complex and controversial and the operation entails higher risks.

Therefore performing this type of procedure requires the surgeon to have a high level of technical skill and it is critical to choose the best time for the operation. In the best of cases, surgery stops the progression of vision loss, but it does not return lost vision, as is the case in cataract surgery. It is therefore of little use if it is performed too late, while it may involve significant and unnecessary risks if performed too soon. So it is extremely important that everyone, especially the relatives of patients with glaucoma and other groups at risk, have regular checkups so that, as the case may be, glaucoma and ocular hypertension can be diagnosed as early as possible.

The subspecialty of glaucoma and ocular hypertension is our team’s main subspecialty. The director, Dr. Tsiplakos, has been focused on the field of Glaucoma / Ocular Hypertension since his days of training at Clínica Barraquer in Barcelona (1997-2001). He subsequently worked for several years as a surgeon at the Glaucoma Division of the Hospital de la Creu Roja de l’Hospitalet in Barcelona and at the Institut Català de la Retina (ICR), where he was responsible for large numbers of patients suffering from this disease and where, from 2001 on, he regularly performed all types of surgery for glaucoma. Since 2004, he has performed the same types of surgery in Girona at the Ophthalmology Unit of Clínica Quirúrgica Onyar. At present we are able to offer our patients the complete range of glaucoma diagnostic tests, medical monitoring and treatment, laser treatments (trabeculoplasty, etc.) and just about every available surgical technique and implants for the management of glaucoma:

• Trabeculectomy
• Non-penetrating deep sclerectomy
• Ex-PRESS shunts
• Cyclodestructive procedures
• Placement of valve and non-valved drainage devices (Ahmed, Molteno, etc.)
• Minimally invasive surgeries (I-Stent)
• Others

In our quest to constantly strive to make ourselves better, we attend courses, conferences and pay learning visits to prestigious institutions to ensure continuous training of the highest standard. The Subspecialty Day meeting sponsored by the prestigious American Academy of Ophthalmology (AAO) in the U.S., of which Dr. Tsiplakos has been a member since 1997, is an annual not to be missed event.