Glaucoma - severe chronic eye disease, which is characterized by increased intraocular pressure (IOP). In this case, the optic nerve is affected, vision is reduced and the onset of complete blindness is possible. The optic nerve completely dies, and blindness is irreversible.
Unfortunately, glaucoma is quite common; people over the age of forty suffer from it. According to the WHO, in the world the number of glaucoma patients reaches 100 million people. At a younger age, glaucoma is much less common.
Intraocular pressure rises for two main reasons: the formation of intraocular fluid in excessive quantities and the violation of the removal of intraocular fluid by the drainage system of the eye. Retention of intraocular fluid causes an increase in IOP, and high IOP leads to death of the optic nerve and blindness. However, what causes excessive fluid formation is not yet known. It is believed that hereditary factors play a huge role in the occurrence of glaucoma. If the family has relatives who have glaucoma, it is necessary at least once a year to undergo an examination with an ophthalmologist.
Neglect of treatment for glaucoma inevitably leads to blindness.
There are several types of glaucoma:
Congenital Glaucoma, which can be caused by genetic causes or diseases and injuries of the fetus during periods of embryonic development or childbirth. Congenital glaucoma appears in the first weeks of life. The disease is quite rare - 10-20 thousand newborns account for only 1 case of glaucoma.
The cause of the disease is most often heredity of an autosomal recessive type. In this case, anomalies of the eyeball are observed. The reasons may be the impact on the fetus of diseases such as measles rubella, flu, toxoplasmosis, mumps, hypoxia.
Juvenile or juvenile glaucoma. It develops in children after three years and young people under 35 years of age. The causes of the disease are congenital changes in the iris of the eye.
Secondary glaucoma - this is a consequence of other ocular or general diseases in which the eye structures responsible for the circulation and outflow of intraocular fluid from the eye are affected. Causes may also be mechanical damage to the eye.
Primary Adult Glaucoma - The most common type of chronic glaucoma, which is associated with age-related eye changes. The disease is divided into 4 main clinical forms: open-angle glaucoma, mixed glaucoma, angle-closure glaucoma and glaucoma with normal IOP.
Symptoms of Glaucoma
Symptoms of glaucoma directly depend on the form and stage of development of the disease. Its cunning is that at the initial stage of the disease, 80% of patients do not experience any inconvenience. What should alert:
- Symptoms of primary glaucoma or, as it is also called, primary glaucoma, that is, one of the forms of closed-angle or open-angle glaucoma, this rainbow circles. When looking at a light bulb or a candle flame, it seems to the patient that the fire is surrounded by a rainbow halo.
- The appearance of a "mesh" in front of the eyes, pressing pains in the eye area, sometimes giving off to the head.
- Symptoms also include periodic "blurring" of vision, the appearance of a "veil", most often in the morning, a decrease in visual acuity at dusk, and then under normal lighting, a narrowing of the angle of view.
- When examined by a specialist, there is swelling of the cornea and iris.
- Pressure measurement shows increased values, the patient is nauseous.
Congenital glaucoma in children is manifested by stretching of the cornea, which is elastic in newborns and assumes normal sizes after the first week of life. With glaucoma, the eyes seem more expressive and more than normal. This leads to stretching and thinning of the retina and its further detachment with breaks.
Observed myopia or myopic astigmatism, a slight increase in intraocular pressure in the early stages of the disease. Corneal edema occurs, which leads to visual impairment, and in the future it is associated with atrophy of the optic nerve and deformation of the fundus.
The main objective in the treatment of glaucoma is the preservation of visual functions with minimal side effects from the applied therapy and maintaining the patient’s normal quality of life. The key to successful treatment is the patient's correct understanding of the serious prognosis of the disease and the need for adequate treatment.
Glaucoma is treated conservative (drug) method, laser and surgical by way. Drug treatment, in turn, is carried out in three directions: ophthalmic antihypertensive therapy - measures aimed at reducing intraocular pressure. Measures aimed at improving blood supply to the inner ocular membranes and the intraocular part of the optic nerve. Normalization of metabolism (metabolic processes) in the eye tissues to affect the dystrophic processes that are characteristic of glaucoma. The symptoms of glaucoma and its complications are stopped.
Pilocarpine, a drug that narrowes the pupil of the eye, was previously used to treat glaucoma with medication. Now he has been replaced by new drugs: Betoptic, Betadine, Timolol, Trusopt, Xalatan and a number of others. The latest drugs allow a more targeted effect on glaucoma: to reduce fluid production and improve its outflow.
Laser treatment became possible not so long ago, after the creation of modern ophthalmic laser systems with a certain set of parameters that affect the structures of the eyeball. This made it possible to develop and apply the most diverse methods of laser treatment of glaucoma.
Laser treatment of glaucoma has several advantages: firstly, the low invasiveness of the procedure, secondly, the complete absence of serious complications that may arise in the postoperative period, thirdly, the possibility of treatment on an outpatient basis, which significantly affects the savings, the possibility of , if necessary, repeated laser interventions, with a significant decrease in the hypotensive effect in the postoperative period.
Laser treatment for glaucoma conducted by the following methods:
- laser trabeculoplasty;
- laser iridectomy;
- laser gonioplasty;
- laser trabeculopuncture (outflow activation);
- laser descemetogoniopuncture;
- laser transscleral cyclophotocoagulation (contact and non-contact).
Surgical treatment consists in creating an alternative system for the outflow of intraocular fluid, after which normalization of intraocular pressure occurs without the use of medications.
Different forms and types of glaucoma suggest a difference in surgical intervention and are resolved, each time, individually. An exception is congenital glaucoma in children, this form of the disease is treated only by surgical methods.
The doctorsspecialization: Optometrist (ophthalmologist)
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Glaucoma is perhaps the most common cause of blindness, and therefore the prevention of disease progression is of great socio-economic importance to both the individual and society as a whole.
The course of the disease largely depends on the lifestyle of the patient, the treatment of glaucoma cannot be successful without lifestyle correction. Physical and nervous overload should be avoided, especially at an older age. Allowable maximum weight for lifting must not exceed 10 kg. It should also not be read in low light and for a long period.
Of great importance is the diet, you need to eat rationally, according to age. Preference should be given to vegetable dishes, fish, raw vegetables and fruits and limit the intake of animal fats and sugar. Nicotine is very harmful to the eyes, therefore, it is better to give up smoking, the sooner the better.
The most effective in the prevention of glaucoma is a systematic examination by an ophthalmologist and control of intraocular pressure for people over 40-45 years old. You need to visit a doctor at least once a year. Particularly attentive to the prevention of glaucoma should be people who have relatives with glaucoma.
In the event that the first symptoms of glaucoma appear, you should immediately consult a doctor. If any form of glaucoma is detected, it is imperative to be under medical supervision at an ophthalmologist. Remember that at present, medicine does not have the ability to restore vision lost as a result of the progression of glaucoma.
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List of sources
- Glaucoma. National Leadership / Under. ed. E.A. Egorova - M .: GEOTAR-Media, 2013.
- Nesterov, A.P. Classification of glaucoma / A.P. Nesterov, E.A. Egorov // Clinical Ophthalmology. - 2001.
- Somov E. E. Clinical Ophthalmology. - M., 2005.