Glaucoma is a leading cause of irreversible blindness globally, characterized by progressive damage to the optic nerve often linked to elevated intraocular pressure. Early detection is critical because the disease is frequently asymptomatic in its initial stages. In Italy, approximately one million people are affected, with estimates suggesting that half are unaware of their condition.
Understanding the Progression of Glaucoma
Glaucoma is a chronic condition that typically targets the peripheral vision first. Because central vision often remains intact until the disease reaches an advanced stage, patients frequently do not notice the onset of symptoms until the optic nerve damage is permanent.
"The most insidious characteristic is that it initially affects the peripheral field of vision," explains Andrea Rossi, an ophthalmologist at the Glaucoma Clinic of the Ospedale di Cremona. "Patients often reach a diagnosis only when the disease is already in an advanced phase."
Medical professionals emphasize that while vision loss from glaucoma cannot be reversed, early intervention can stabilize the condition. Regular eye examinations are recommended, particularly for individuals over the age of 60 or those with risk factors such as arterial hypertension, diabetes, and cardiovascular disease.
How Minimally Invasive Glaucoma Surgery (MIGS) Works
When pharmaceutical treatments, such as medicated eye drops, fail to control intraocular pressure, clinicians may transition to laser therapy or surgical intervention. Minimally Invasive Glaucoma Surgery (MIGS) has emerged as a specialized option for patients who require more than medication.
The procedure involves the implantation of micro-drainage valves, which are only fractions of a millimeter in size. Surgeons insert these devices through a small incision into the trabecular meshwork—the structure responsible for regulating fluid drainage within the eye. By bypassing the obstruction, these valves facilitate better fluid outflow and help reduce intraocular pressure.
Benefits and Recovery Expectations
MIGS procedures are performed under local anesthesia and are generally completed in a few minutes without the need for hospital admission. Patients are typically discharged after a short period of clinical observation.
"Compared to traditional surgery, this technique is less invasive, involves a simpler post-operative course, and allows for faster visual recovery," notes Rossi.
Data from the Oculistica department at the ASST di Cremona, which began implementing these techniques in late 2025, suggest positive outcomes for selected patients. Early results indicate a consistent reduction in intraocular pressure without significant complications. While this surgical approach does not replace conventional surgery, which remains the treatment most indicated in many situations, it provides a viable therapeutic pathway for patients who meet specific clinical criteria.
Frequently Asked Questions
Why is glaucoma considered a "silent" disease?
It is considered silent because in its initial phases it does not cause obvious symptoms and can evolve slowly without the person noticing. By the time a patient notices a decrease in their field of vision, the optic nerve has often sustained irreversible damage.
Who should be screened for glaucoma?
Screening is particularly important for individuals over 60, those with a family history of the disease, and patients with underlying health conditions like diabetes, high blood pressure, or heart disease.
Is MIGS suitable for every glaucoma patient?
No. MIGS is a specialized intervention for selected patients. Traditional surgery remains the treatment most indicated in many situations, and ophthalmologists evaluate each patient’s specific anatomy and disease progression to determine the most appropriate surgical path.