FIXED COMBINATIONS IN THE TREATMENT OF GLAUCOMA

Abstract

Glaucoma is a slowly progressive neuropathy with changes in the optic nerve, the retinal neurofibrillar layer, and the field of vision.The aim of the paper is to present the significance of detecting elevated intra ocular pressure in early glaucoma detection.Glaucoma is one of the leading causes of blindness in the world. According to the latest WHO estimates, as a challenge to global level resolution - carcinomas are in the first place, cardiovascular diseases in second, and blindness in third place. The glaucoma accounts for about 9-12% of all blind people in the world, that is, this disease is diagnosed in about 2.5 million people each year. WHO predicts that the percentage will increase to 30% by 2020.The definition of the 2014 European Glaucoma Association (EEC 2014) reads: "Glaucoma is a chronic progressive optic neuropathy with characteristic morphological changes on the optic nerve disc and the retinal neurofibrillar layer as well as the progressive death of ganglia cells with visual field loss in the absence other eye diseases and congenital anomalies. " Hence, in addition to the standard methods available to us, such as measuring the height of the intraocular pressure (IOP), gonioscopy, eyelid examination, as well as determining and monitoring visual acuity, the necessity of the standard computerized perimetry and optic coherent tomography of back eye segment.Timely diagnosis of glaucoma is the only mechanism to combat this disease. The new methods offer a variety of new possibilities for investigating the earliest changes in the optic nerve disc and the retinal neurofibrillar layer. Their use should be combined with the classic glaucoma testing methods, such as standard computerized perimeter. But the basis is the early detection of an increased IOP by means of mass measurements with screening programs in risky or general groups. According to modern ophthalmic protocols, all patients with an increased IOP must be computed perimetrically once a year. In patients with significant changes in the field of vision, more often, for six months, the findings of the visible fields are compared. The new methods provide a quick, precise and timely diagnosis of this severe disease, which, if not detected, leads to safe blindness in time. Early combination therapy may be appropriate in patients with advanced glaucoma, patients with a high progression rate in patients with high IOP and / or severe visual field impairment, as well as in younger patients. Fixed combination therapy should be considered when patients fail to achieve their individualized IOP targets with monotherapy when 2 special applications of drops are preferred.