Glaucoma : symptoms, causes and treatment .Surgery for Glaucoma

Category Visual Disturbances And Blindness | August 12, 2017 18:01

Contents:

  • Causes Glaucoma
  • forms and basic signs of glaucoma
  • Diagnosis Glaucoma Treatment

Translated from the Greek "glaucoma" means "green color of the sea."The first mention of diseases related to the 5th century BCThere they were in the works of Hippocrates.A more modern interpretation dates back to 9 century AD

Nowadays this term to denote a group of diseases in varying degrees different from each other in origin and the clinical picture.No treatment or improper treatment of glaucoma can lead to atrophy of the optic nerve and blindness.

Glaucoma is a very common chronic eye disease.It is characterized by increased intraocular pressure, optic nerve damage, resulting in a gradual decrease until the loss of vision.Can not restore it, as blindness is a consequence of the death of the optic nerve.

The disease affects mostly people of middle (older than 40) and older.But it can also occur in young infants.In the first case we are talking about juvenile glaucoma, the second - a congenital for
m of the disease.

Causes Glaucoma

Causes of glaucoma can be divided into local and general.

Local - is taking place in the drainage system of the eye changes that result in increased intraocular pressure.Index of intraocular pressure - the value is quite individual, but generally it varies between 16 and 25 mm Hg for Maklakov tonometer.

At equilibrium between the amount produced in the eye and flowing liquid from it provided the immutability of intraocular pressure.

Its increase may be the result of two causes:

  1. Development of intraocular fluid in large quantities.
  2. Violation fluid removal process through the eye drainage system due to take place in her lesions.

a result of accumulation of fluid is increased intraocular pressure, which eventually leads to the death of the optic nerve.

Among the reasons of a general nature should be mentioned the following:

  • hereditary factor;
  • hemodynamic and neuroendocrine disorders;
  • low blood pressure;
  • changes in the cervical vessels bearing the sclerotic character;
  • cervical osteochondrosis.

These factors adversely affect the blood circulation in the brain, so that there is an infringement of metabolic processes in the tissues of the eye and the optic nerve and, as a result, deterioration of visual function.

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forms and basic signs of glaucoma

Common symptoms are:

  • increased intraocular pressure;
  • changes in the optic nerve;
  • reducing the field of view.

customary to distinguish several types of glaucoma.

Open- - the most insidious and the most common form.In the initial stage it can not manifest itself in any way.Increase intraocular pressure is moderate, whereby the patient does not perceive it.But even with a slight increase in this indicator in the optic nerve start irreversible processes, leading eventually to blindness.

There are some typical symptoms that indicate an increase in pressure inside the eye:

  • appearance before the eyes of "grid";
  • blurred vision;
  • when looking at the light for a light source - the presence of bright circles;
  • feeling of tension and heaviness in the eye;
  • small pains and stinging;
  • feeling of moisture;
  • poor night vision;
  • minor pain.

closure first type glaukomyotlichaetsya paroxysmal over.

When an acute attack greatly increases the intraocular pressure - it can be up to 60-80 mm Hg.column.There are severe pain in the eye, often accompanied by headaches, nausea, vomiting, general weakness.There is a sharp decrease of the patient's eye.

acute angle-closure glaucoma is difficult to diagnose: it is often mistaken for a toothache, headache, flu, meningitis, stomach disease, because patients complain of nausea, headaches, etc., with no mention of the eye.

Congenital glaucoma occurs in newborns.The child record increased intraocular pressure.In some cases, the eyeball can be increased.

reason for this form of the disease - congenital deficiencies of the drainage apparatus of the eye.If a slight defect in the disease can be diagnosed much later - in childhood or adolescence.

secondary form of glaucoma is the result of trauma or other eye diseases: vascular, inflammatory, degenerative, lens pathologies, etc.

In secondary type of intraocular pressure rises as a result of violations of the outflow of intraocular fluid and delays.

Glaucoma can occur with a normal or low intraocular pressure.Moreover, its occurrence is related to impaired blood circulation in the eye, also leading to a narrowing of borders and reduction of visual acuity, optic nerve atrophy.

mainly developing glaucoma in both eyes, but the second eye may be affected after a few months (or even years) after the first.

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Diagnostics

Determine the onset of the disease is possible by measuring intraocular pressure.But it is not sufficient for an accurate diagnosis.

also carried out a survey of the optic nerve and the ocular fundus.Detailed audit exposed a field of view of the patient.This is only possible as a result of large-scale diagnostic examination.

It includes:

  1. Computer perimetry - diagnostic method consisting in the field of study, produced on a spherical surface to detect defects and determine the boundaries.Inspection is carried out using special devices in the form of a hemisphere or an arc - perimeters.
  2. eye refraction measurement (its ability to refract light rays).
  3. Ultrasonography.
  4. Measurement of lens thickness and anterior chamber depth.
  5. Gonioscopy - study of the anterior chamber angle of the eye, for which there is fluid outflow.

Early detection allows early treatment and stop the development of the pathological process.

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Glaucoma treatment

Methods for the treatment of glaucoma are selected individually and depend on the form of the disease, its stage, the presence or absence of comorbidities.

Drops

eye drops for glaucoma are used to lower the intraocular pressure.Depending on the cause effects, they are divided into three groups:

  1. Drugs that reduce the amount of intraocular fluid (carbonic anhydrase inhibitors, adrenergic blockers): trusopt, timolol, Betoptik.
  2. Eye means for normalizing the outflow of intraocular fluid of the eyeball (lantanoprost, miotics): Xalatan, Travatan, pilocarpine.
  3. Combination drugs double action: proksofilin, fotil (pilocarpine + timolol).

Eye drops can be used only on prescription and subject to continuous monitoring of intraocular pressure.

unacceptable to use these drugs alone or replace their counterparts.

Ocular Instruments

As an additional means of ophthalmologists advise physiotherapy techniques aimed at the normalization of intraocular pressure and stabilization of vision.
It is recommended to use special equipment - for example, Points Sidorenko.They have on the eye and surrounding tissue through the combined effect of infrasound pneumomassage, phonophoresis and color impulses.

This device is used as in glaucoma, and in many other diseases of the eye: nearsightedness, farsightedness, cataracts, etc.

Eyesight Enhancing Vitamins

As a result, a number of studies have shown that the use of specially designed for vitamin-mineral complexes can be very effective for a given disease.

These drugs are used as a complement to the main course and in many cases make it possible to save the patient's vision.The most popular are the lutein-containing agents: Lutein Complex Lutein Forte.

In spostav drugs include lutein in the correct format needed to improve vision vitamins (A, C, E), minerals (zinc, selenium, copper).

Together, these elements fully support visual function: Lutein is an excellent protection against the effects of free radicals contained anthocyanidins in blueberries have a beneficial effect on visual acuity, vitamin and mineral components relieve fatigue and reduce the manifestations of age-related changes in the eye tissues.

Operation

If medical treatment is not enough, use laser surgery or surgery.

Their goal is to create a new path for the outflow of the fluid to reduce intraocular pressure.

This method of treatment of glaucoma is called non-penetrating deep scleroticectomy (NDSE).Its obvious advantage is less traumatic: do surgery without opening the eyeball, thereby excluded penetration of infection and the occurrence of complications.

scleroticectomy performed under local anesthesia through a 2-2.5 mm incision using an excimer laser and special microsurgical tools with diamond or sapphire high-strength blades.

feature penetrating deep sclerectomy - surgical thinning of the peripheral portion of the corneal membrane, which has a natural moisture resistance, in order to facilitate the process of outflow of intraocular fluid from the anterior chamber.

If necessary, a special collagen implant as drains, preventing scarring, which significantly reduces the effect of the operation.

Improved operation is achieved by using argon, excimer, YAG lasers.

NDSE duration - up to 20 minutes.

Patients with a diagnosis of "glaucoma" should remember that the self can lead to vision loss.Only by obtaining timely expert assistance is possible inhibition of the progression of the disease and prevent blindness.