[Glaucoma in the over-eighties].
Due to the recent rapid increase in the aging population, glaucoma in the over-eighties population will become a significant problem of ocular health in the coming decades. It is important to determine the natural effects of aging on the optic nerve head and aqueous humor dynamics in these patients for early diagnosis and monitoring of glaucoma. Its characteristics, context, management, and treatment are very perceptibly different from those of the younger glaucomatous patient. For many reasons, such as its frequent association with macular age-related degeneration, diagnosis of glaucoma in the over-eighties may be difficult. Management of the over-eighties glaucoma is frequently difficult and time-consuming. Less aggressive than in a younger patient and based on topical medications in most cases, it must be discussed case by case and will be based on the general context, the quality of compliance, and especially on the potential consequences of the glaucomatous visual-field defects on the patient's quality of life. In any case, overtreatment as well as treatments that are too complex must be avoided. Given the reduced metabolism in the very elderly, the safest medications must also be selected. It is important to always consider glaucoma medications as part of the patient's medicine regimen. Associated risk factors, especially concomitant systemic hypotension, will be simultaneously treated. Laser trabeculoplasties probably have broader indications than in younger patients. Except for phacoextraction, which is very frequently helpful in controlling IOP, incisional filtering procedures or laser diode cyclophotocoagulations remain infrequently indicated in over-eighties glaucoma patients.
Cliniques Universitaires St Luc, Université Catholique de Louvain, Bruxelles, Belgique. detry@ofta.ucl.ac.be
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Detry-Morel
D000367:Age Factors; D000369:Aged, 80 and over; D000375:Aging; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005901:Glaucoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D019636:Neurodegenerative Diseases / Q000150:complications; D011788:Quality of Life
D000959:Antihypertensive Agents