Glaucoma: Symptoms, Causes, Diagnosis, Prevention and Treatment
Mar 05, 2018
In a healthy eye, the balance of inflow and outflow of fluid is physiologically adjusted.This process provides a constant value of intraocular pressure.Glaucoma is a violation of the normal circulation of fluid in the eye, which is manifested by its accumulation and increased intraocular pressure.This condition negatively affects, first of all, the innervation of the eye and its blood supply.
Glaucoma is not just a nosological form, it is a whole separate group of eye pathologies.Constant or periodic increase in intraocular pressure leads to the fact that at the beginning of the pathological process the pupil of the diseased eye becomes blue-green of a rather specific color, it can be expanded and immobile.Such changes often provoke complete blindness.Table of contents: Causes of glaucoma Types of glaucoma Glaucoma: symptoms Diagnosis Treatment of glaucoma Glaucoma removal surgery Glaucoma prevention
Important : , it is necessary to start the treatment of glaucoma as soon as possible after it is diagnosed.Only this will avoid a complete loss of vision, since pathological changes in glaucoma are irreversible.
Atrophy of the optic nerve and decreased vision are manifested by the fact that the patient complains of peripheral vision impairment, there is a limitation of the visibility zone, up to blindness.
There are cases of glaucoma with normal intraocular pressure.In this case, the pressure has the value of the upper limit of the norm, but in the optic nerve the circulation of blood is sharply worsened, therefore its functions are violated.
There are the following factors that can trigger the development of glaucoma:
- age after 40 years;
- genetic predisposition;
- trauma to the eye;
- swelling of the eye;
- is an inflammatory process in the tissues of the eye;
- taking certain medications that promote the dilatation of the pupil;
- age-related vascular pathology;
- features of the profession( constant work in an inclined position, night shifts, etc.).
Types of glaucoma
There are two types of glaucoma regarding the time of appearance of the glaucoma:
- acquired, which develops as a result of adverse effects on the body of various external factors;
- congenital is the result of anomalies or defects in the intrauterine development of the fetus because of its infection, it is very rare, affects children, is treated promptly.
Glaucoma can also be:
- closed-angle( ZUG) - it is diagnosed in patients after 30 years, it is characterized by a sharp increase in pressure;
- open-angle( OUG) - is detected in 9 out of 10 cases of glaucoma, with it the fluid accumulates slowly, and the pressure rises gradually.
Regarding the degree of progression, glaucoma is unstabilized and stabilized.
Given the degree of compensation, the following are distinguished:
- decompensated glaucoma, with an acute attack and very severe visual impairment;
- compensated glaucoma - does not have negative dynamics;
- subcompensated to glaucoma - is characterized by a negative dynamics of development.
The danger of this pathology is that it often occurs asymptomatically.That is, the patient does not make any complaints from the eyes.Usually it is detected during a regular medical examination.But still, the angle-closure glaucoma has some symptoms.Symptoms of closed-angle glaucoma:
- with her there are irregularities in the structure of the front parts of the eye;
- there are pain in the eye;
- between the cornea and the iris constricts the space;
- fluid inside the eye does not find outflow;
- severe intraocular pressure occurs;
- headache from the patient's eye;
- redness of the eye;The
- appears before the eye with iridescent circles.
Note: with an angle-closure glaucoma can be quite a sharp attack, which is an indication for emergency hospitalization.If you do not provide medical assistance on time, the patient will become blind within a matter of hours.
Open-angle form is the kind of disease with which ophthalmologists are most often found in their practice.In this case, the front of the eye looks normal, but it gradually accumulates a large amount of fluid, which causes an increase in eye pressure.Such a process is the result of the lack of the necessary outflow of liquid.
Congenital glaucoma in children is manifested by the following symptoms of :
- eye fascination in size;
- increased cornea.
If any of the above signs of glaucoma occur, you should immediately visit an ophthalmologist.
Please note: should urgently make an appointment with an ophthalmologist if the following symptoms of glaucoma appear: a feeling of pressure or pain in the eye, a periodic appearance before the eyes of iridescent circles when viewing light sources, blurring of vision.
For the diagnosis of the disease, the doctor will assign a series of examinations:
- Objective examination.The doctor collects an anamnesis, asks the patient about complaints, conducts an ophthalmologic examination.In the presence of concomitant pathologies that could provoke the development of glaucoma, they often prescribe consultations of such specialists as neurologist, cardiologist, therapist, endocrinologist.
- Laboratory diagnostics.It includes the purpose of the assays:
- Biochemistry of blood.
- Blood test for sugar.
- Instrumental diagnostic measures.
Instrumental methods for diagnosing glaucoma include:
- Perimetry, in which the doctor examines the patient's visual fields.
- Tonometry or antonotometry is the determination of the value of intraocular pressure.
- Pachymetry is a study that involves measuring the thickness of the cornea.
- Tonography( electronic) is the study of the quality of the process of outflow of intraocular fluid.
- Ophthalmoscopy( laser) is used to obtain data on the color and structure of the optic nerve in the form of qualitative and quantitative disorders.
- Determination of nerve fiber thickness measurements.
- Gonioscopy is the procedure for calculating the angle between the iris and the cornea of the eye.
Any given technique allows to obtain a sufficient amount of necessary information for assessing the state of the patient's eye.Sometimes just one instrumental sequence is enough to confirm the diagnosis of glaucoma.
Treatment of glaucoma
Important : The effectiveness of the selected treatment for glaucoma depends on the stage at which the disease was found.
Modern ophthalmology offers two types of therapy for glaucoma :
- is a medicament.
Drugs and drops for the treatment of glaucoma are prescribed for certain indications and usually - at the initial stages of its development.
With their help it is possible to achieve:
- normalization of metabolism in the eye tissues;
- improved blood supply to the inner shell of the diseased eye and optic nerve,
- decreased high figures of intraocular pressure.
Ophthalmopotensive therapy takes a leading role in the treatment of glaucoma.In some cases, the patient is sufficient to use glaucoma drops prescribed by the doctor, and the disease will cease to progress.At any kind of glaucoma - drops - this is the first method of treatment.
Please note: medications for glaucoma are prescribed with the goal of to reduce intraocular pressure, but they can not restore the fluid balance in the eye itself, but simply maintain it artificially.
In the treatment of this disease it is also important to adhere to certain rules and recommendations of the doctor, helping to avoid an acute attack or the progression of glaucoma.
9 rules that will help you slow the course of the disease:
- Strict implementation of the doctor's recommendations.
- Take drops with glaucoma to work or travel.
- It is necessary to reduce the level of stress.
- It is important to avoid excessive physical exertion( the maximum permissible weight is 10 kg).
- Avoid prolonged exposure to darkness, because eye pupils widen in it and this causes an increase in pressure inside the eye.
- In the diet for glaucoma should be products of vegetable origin( especially - cabbage, prunes, bread, coarse grind), kefir.
- Important point - the restriction of sharp, fatty, salty and meat dishes, coffee, tea.
- Drinking regimen should be observed in a volume not exceeding 5-6 glasses per day.
- It is important to completely abandon cigarettes and alcohol.
Operation to remove glaucoma
Operation for glaucoma is indicated in the following cases:
- 3-4 stage of severity of glaucoma;
- acute attack of glaucoma;
- lack of effectiveness of drug therapy.
Glaucoma can be removed through many modern technologies, but they all have one single goal - to reduce the pressure inside the eye.Most often, a microsurgical scalpel is used to open the eyeball or laser.
Note: to Unfortunately, even with the rapid progress of technology in the medical world, this eye disease can not be cured.Therefore, even after surgery for glaucoma, it is necessary to visit a doctor and undergo an ophthalmic examination.
Laser surgery for glaucoma is a trabeculoplasty or an iridectomy.These techniques are based on local tissue rupture in the form of micro-explosions or burns with subsequent scarring.The important advantages of laser treatment of glaucoma:
- short rehabilitation period;
- for local anesthesia apply local anesthesia;
- this operation can be carried out in an outpatient setting;
The inherent nature of this technology and a number of shortcomings.In particular, when using a laser, there is a risk of only a limited effect.Therefore, with mature glaucoma, only radical surgery is practiced.
Surgery can be performed in several versions:
- and iridectomy;
Note: in each case of glaucoma, doctors use an individual treatment plan and type of surgery, because there is no single standard of therapy for this disease.Mostly everything depends on the patient's condition, concomitant pathologies, the stage of glaucoma, the presence of complications.
Even after the operation with glaucoma, it is impossible to completely restore lost vision or nerve damage.Modern techniques allow only to slow down this pathological process or to stop its progression.The purpose of their use is the normalization of intraocular pressure, but all pathological changes that have occurred before are irreversible.
Prevention of glaucoma
Prevention of the development of glaucoma includes the following prevention measures:
- prophylactic examination with an ophthalmologist after 40 years regularly;
- when at risk, ophthalmologic examination should be performed more often than usual( after eye surgery, if there is hyperopia, predisposition to glaucoma);
- it is important to regularly check the intraocular pressure after trauma or injury to the eye in order to avoid the development of secondary glaucoma;
- Use eye drops with cortisone content strictly according to the instructions, since exceeding the dosage or prolonged use may cause cortisone glaucoma( secondary).
Alas, in a number of cases, they can not provide a 100% result either.
How to preserve vision in diagnosed glaucoma, can the development of the disease be prevented and are effective prevention measures available?Answers can be found in the video review:Viktorova Julia, obstetrician-gynecologist