Implementation of the national clinical protocol for solving the problems of primary open-angle glaucoma in adults

Abstract

Background. Glaucoma is the leading cause of irreversible and the second leading cause of preventable blindness worldwide. Its prevalence, in people over the age of 40, is about 2-3%, and in those over 80 - 14%. Glaucoma is a pathology characterized by progressive and irreversible atrophy of the optic nerve and gradually affects the visual field, often causing blindness. Increased IOP is a major risk factor, which worsen the evolution of diseases. The diagnosis is based on ophthalmological examination and instrumental investigations such as: OCT of the optic nerve and macula, perimetery, pachymetry. Conservative treatment of glaucoma starts with eye drops in order to achieve target IOP, improve blood supply to the eyeball and maintain visual function. Laser treatment is indicated when eye drops are inefficient. Surgical treatment is initiated if first two fail. Trabeculectomy, Trabeculotomy, Deep Sclerectomy, Viscocanalostomy and Canaloplasty may be done. In order to diagnose and treat patients with primary glaucoma was created a national clinical management protocol. It includes all necessary steps and algorithms, criteria and advices to provide high quality medical services and has a targeted circle of users. Conclusions. This protocol aims to early detection of primary glaucoma in adults, reducing its negative impact on vision, initiation of treatment as soon as possible and supervision of patients, all to avoid disability and improve patient’s quality of life. It should be used by ophtalmologists, optometrists, family doctors and their nurses.