Pathogenesis and conservative treatment of glaucoma]

Glaucoma is a chronic disease which, if not treated, can lead to blindness. The reason for deterioration of function is neuropathia n. optici developed during the disease. Earlier increased ocular tension was considered to be the cause of neuropathia. By now we have realised that increased ocular tension (that above 21 Hgmm) in only one of the risk factors. The decay of optic nerve fibres is caused by circulatory failure on the one hand, and by the necrosis of ganglion cells on the other hand. In the conservative treatment of glaucoma pilocarpin was used earlier but nowdays the first place has been taken over by the group of betareceptor blockers, which are applied twice a day in the form of dropping. If this proves unsatisfactory, the treatment is complemented with carbonanhydrase inhibitor-drops 2-3 times daily. In certain cases this is followed by prostaglandin F2alfa analog drops once a day, dripped in the evening hours. Carboanhydrase inhibitor can be administered per oral as well: 1-2 times weekly. This latter cannot be given continuously: it is only a temporal solution for a few months in addition to other conservative therapy. Cholinerg drops can join in at any time of conservative treatment. The future method of conservative therapy is the combination of drops with varions effect, which decreases the frequency of daily drippings and enhances the efficacy of treatment.