Definition and basic types of glaucoma
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| What is glaucoma |
Article Content:
- Glaucoma - What is glaucoma.
- Glaucoma treatment in Moscow.
- Glaucoma - Figure?
- CONTRAINDICATIONS FOR THE OPERATION.
- RISK GROUPS.
Glaucoma - What is glaucoma:
The traditional definition of glaucoma is that the term brings together a large group of eye diseases characterized by the continuous or periodic increase of intraocular pressure, due to violations of the outflow of aqueous humor from the eye. The consequence of increasing pressure is the development of characteristic of glaucoma disorders visual function and atrophy with the excavation of the optic nerve (AP Nesterov, 1995). (Figure ?1)
Glaucoma is divided.
1. By origin: Glaucoma - Figure ?1. The head of the optic nerve (of OH) - a place of application of pathological changes in glaucoma
Primary - related violation of the drainage system of the eye, and as a consequence of the deterioration of the outflow of intraocular fluid;
secondary, which arises as a result of other eye diseases (inflammation, cataract, diabetic changes thrombosis, injury, tumor, etc.) or after eye operations;
concomitant associated with defects of the eye or other structures of the body.
2. By the age of the patient:
congenital (seen up to 3 years);
infantile (from 3 to 10 years);
juvenile (from 11 to 35 years);
adult glaucoma.
3. On the mechanism of increased intraocular pressure
otkratougolnaya,
closure.
4. The level of intraocular pressure:
with elevated IOP (intraocular pressure);
with normal IOP.
5. the extent of damage to the optic nerve. Stages of glaucoma:
I-initial (boundaries of the visual field are normal, but there are small changes in the paracentral parts of the visual field); (Figure ?3)
Glaucoma treatment in Moscow
The cost of laser surgery for glaucoma - from 40 to 55 000 rubles (one eye), including anesthesia, hospitalization.
Laser vision correction in Moscow
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Surgery to LASIK technology.
All actions of the excimer laser are controlled by a computer program, in which the pre-stored individual parameters of the patient's eye, which completely eliminates the medical error.
The rehabilitation period after surgery - 2-3 hours. Then you can drive a car, read, watch TV, work on a computer.
The cost of laser correction - 60 000 rubles (both eyes).
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6. Adrift disease
Among glaucoma isolated congenital and acquired glaucoma. Congenital glaucoma is not as common and treatment (surgery) performed in children's wards of hospitals at an early age. Most often faced with primary open-angle glaucoma, which is the beginning goes unnoticed for a man (no worsening of pain, "veil") and this, in turn, leads to the progression of the disease and ophthalmologists have to deal with severe advanced cases, when it comes the only question is the preservation of residual vision, and sometimes to relieve pain, to save the eye. (Figure ?2)
Glaucoma - Figure?
2. The progression of glaucoma vision loss (typical picture of changes in the field of view)
The acquired glaucoma release: age (primary open-and-closure glaucoma), the secondary, which is associated with injury to the eyes and other eye diseases or organism (eg, diabetes), after an eye surgery (eg, cataract) or inflammation (eg, uveitis, iridocyclitis). The second occurrence is closure glaucoma views. Almost always manifested acute attacks (with severe pain, blurred vision). In this case, it needs urgent help - hospitalization and holding soon antiglaucoma operations.
Further on we are faced with the occurrence of secondary glaucoma (more on diabetes as a consequence of suffering a thrombosis, etc.).
Separately want to highlight glaucoma with normal IOP. Difficulties in establishing the diagnosis are the prevailing stereotypes that glaucoma - it is always a high intraocular pressure. Most often in these cases, the pressure is held in the area of ??the upper limit of normal, but the blood flow in the optic nerve has deteriorated sharply, and therefore its function is impaired.
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Early detection and proper treatment of glaucoma to avoid irretrievable blindness! All patients over the age of 40 years are highly recommended measuring intraocular pressure in any appeal to the eye doctor. Glaucoma treatment in each case is individual, may consist of a combination of various methods and passes only the active participation of the attending physician.
Diagnosing glaucoma
Examinations for glaucoma include:
measurement of intraocular pressure (tonometry);
definition of the visual field (perimetry);
study of the fundus.
Open-angle glaucoma is dangerous because its appearance can go unnoticed for a long time and it felt a distinct change of the person only when the disease is in an advanced stage. That is why all patients after 40 years should be measured intraocular pressure in any appeal to the eye doctor (at least 1 time in 6 months). Glaucoma exposes destruction of nerve fibers of the retina and the optic nerve, which can not be recovered. At the initial stage narrow field of view at the periphery, but no pain and visual acuity may still be quite high.
symptoms of glaucoma
In severe pain in the eye, as well as the sudden appearance of a headache in the forehead and temple of the affected eye, nausea can be suspected closure glaucoma. An acute attack of angle-closure glaucoma in its manifestations is similar to some other eye diseases, so prior to treatment you need to make an accurate diagnosis. It is important to provide timely help to prevent vision loss.
Glaucoma is a low pressure when the changes take place against a background of normal intraocular pressure is dangerous because it is difficult to diagnose and is therefore often diagnosed only at an advanced stage.
When the pain in the eye, narrowing the field of view, with visual impairment in the dark, or when the "iridescent" circles when looking at a bright light source is an urgent need to consult a doctor.
Please be aware that the earlier diagnosed with open-angle glaucoma and treatment is started, the more likely to keep and maintain the visual function of the eye.
The decisive factor in the treatment of angle-closure glaucoma attacks is a time to see a doctor. If the attack is not to stop during the first day, this can result in a significant irreversible loss of vision and sometimes even to blindness.
Treatment for any type of glaucoma is directed primarily to normalize intraocular pressure:
with surgery (carried out with the ineffectiveness of drug therapy, after surgery, the patient is relieved to use drops for 5-7 years as required).
In the initial stages of open-angle glaucoma may be quite properly sized drip mode. This usually several types of drops to be instilled from one to three times a day. It should be remembered that it is unacceptable to pass installation or forget about them, at the cost of such errors can be the loss of vision.
laser treatment of glaucoma
If the drops can not effectively reduce intraocular pressure or glaucoma process is already at an advanced stage, and resort to laser surgery. At the same time seeking to improve the outflow of intraocular fluid by natural waterways and/or form new outflow tract.
Laser treatment of glaucoma - laser iridectomy (iridotomy) - is the method of choice in patients with narrow-angle glaucoma or as a complementary treatment to the drops with open-angle glaucoma. The essence of the procedure - in the formation of the non-contact additional ways of outflow of intraocular fluid. The low-impact operation carried out on an outpatient basis and usually does not require special training.
Surgical techniques are used in the case where a drop or laser therapy can not effectively reduce IOP or glaucoma process is already at an advanced stage. The feasibility and the need for surgical treatment are determined by the doctor.
The operation for the treatment of glaucoma ...
painless (performed under intravenous anesthesia)
lasts about 20-40 minutes, the patient,
postoperative period ranging from 1 to 3 weeks (during this period the patient appointed anti-inflammatory drops), discomfort in the eye phenomenon is possible for 5-7 days.
It must be remembered that the treatment of glaucoma, especially in each case individually, may consist of a combination of various methods and passes only the active participation of the attending physician. Self-medication or advice one patient to another - are not allowed.
An acute attack of angle-closure glaucoma in its manifestations is similar to some other eye diseases, so prior to treatment you need to make an accurate diagnosis. Laser and surgical treatment of angle-closure glaucoma are carried out after the attack docked in order to prevent repeated attacks.
To maintain visual function in patients with any form of glaucoma therapeutic conduct courses of treatment, sometimes combining them with small forms of surgery. Currently, it is one of the most promising directions of glaucoma treatment, and in some cases allows for partial and improve vision.
In conclusion, it must be said that glaucoma - a lifelong disease. Even if the treatment is carried out allows intraocular pressure to remain at a normal level for many years, there is no guarantee that the IOP rises will not be repeated. Therefore, patients with glaucoma must be kept under the supervision of an ophthalmologist. Typically, the frequency of inspections is every 3-4 months, depending on the stage of the disease.
Asians, dark skin, dark hair and the iris.
Heredity (if relatives have glaucoma).
The structural features of the eye (the dark color of the iris, a thin cornea, innate characteristics of the structure of the optic nerve, ocular hypertension - an innate characteristic, in which the intraocular pressure in both eyes is much higher than normal, but it does not lead to damage to the optic nerve).
Chronic inflammation of the eye, "neglected" cataracts.
Long hormonal drugs (corticosteroids), if there is bronchial asthma, diseases of the joints or skin, and others.
Diabetes mellitus and hypertension.
eye injury, which led to a breach of its structure.
Myopia or nearsightedness - such people more likely to develop glaucoma with normal or low blood pressure.
severe concomitant diseases of the eye,
if the risk reduction of more than a possible positive effect.
LIST necessary analysis for operations
general analysis of blood, urine,
both.analyze blood (total protein, urea, creatinine, K, Na, blood sugar, bilirubin (fractions),
blood type, Rh factor, blood clotting time (Duke or Sukharev) or coagulation,
HIV, RW, HBs, the HCV, ECG, chest X-ray (photofluorogram), consultation of the therapist, otolaryngologist, dentist.
In diabetes - advice endocrinologist is required.
Diagnosing glaucoma
Examinations for glaucoma include:
measurement of intraocular pressure (tonometry);
definition of the visual field (perimetry);
study of the fundus.
Open-angle glaucoma is dangerous because its appearance can go unnoticed for a long time and it felt a distinct change of the person only when the disease is in an advanced stage. That is why all patients after 40 years should be measured intraocular pressure in any appeal to the eye doctor (at least 1 time in 6 months). Glaucoma exposes destruction of nerve fibers of the retina and the optic nerve, which can not be recovered. At the initial stage narrow field of view at the periphery, but no pain and visual acuity may still be quite high.
symptoms of glaucoma
In severe pain in the eye, as well as the sudden appearance of a headache in the forehead and temple of the affected eye, nausea can be suspected closure glaucoma. An acute attack of angle-closure glaucoma in its manifestations is similar to some other eye diseases, so prior to treatment you need to make an accurate diagnosis. It is important to provide timely help to prevent vision loss.
Glaucoma is a low pressure when the changes take place against a background of normal intraocular pressure is dangerous because it is difficult to diagnose and is therefore often diagnosed only at an advanced stage.
When the pain in the eye, narrowing the field of view, with visual impairment in the dark, or when the "iridescent" circles when looking at a bright light source is an urgent need to consult a doctor.
Methods of treatment of glaucoma
Please be aware that the earlier diagnosed with open-angle glaucoma and treatment is started, the more likely to keep and maintain the visual function of the eye.
The decisive factor in the treatment of angle-closure glaucoma attacks is a time to see a doctor. If the attack is not to stop during the first day, this can result in a significant irreversible loss of vision and sometimes even to blindness.
Treatment for any type of glaucoma is directed primarily to normalize intraocular pressure:
with surgery (carried out with the ineffectiveness of drug therapy, after surgery, the patient is relieved to use drops for 5-7 years as required).
In the initial stages of open-angle glaucoma may be quite properly sized drip mode. This usually several types of drops to be instilled from one to three times a day. It should be remembered that it is unacceptable to pass installation or forget about them, at the cost of such errors can be the loss of vision.
laser treatment of glaucoma
If the drops can not effectively reduce intraocular pressure or glaucoma process is already at an advanced stage, and resort to laser surgery. At the same time seeking to improve the outflow of intraocular fluid by natural waterways and/or form new outflow tract.
Laser treatment of glaucoma - laser iridectomy (iridotomy) - is the method of choice in patients with narrow-angle glaucoma or as a complementary treatment to the drops with open-angle glaucoma. The essence of the procedure - in the formation of the non-contact additional ways of outflow of intraocular fluid. The low-impact operation carried out on an outpatient basis and usually does not require special training.
Surgical techniques are used in the case where a drop or laser therapy can not effectively reduce IOP or glaucoma process is already at an advanced stage. The feasibility and the need for surgical treatment are determined by the doctor.
The operation for the treatment of glaucoma ...
painless (performed under intravenous anesthesia)
lasts about 20-40 minutes, the patient,
postoperative period ranging from 1 to 3 weeks (during this period the patient appointed anti-inflammatory drops), discomfort in the eye phenomenon is possible for 5-7 days.
It must be remembered that the treatment of glaucoma, especially in each case individually, may consist of a combination of various methods and passes only the active participation of the attending physician. Self-medication or advice one patient to another - are not allowed.
An acute attack of angle-closure glaucoma in its manifestations is similar to some other eye diseases, so prior to treatment you need to make an accurate diagnosis. Laser and surgical treatment of angle-closure glaucoma are carried out after the attack docked in order to prevent repeated attacks.
To maintain visual function in patients with any form of glaucoma therapeutic conduct courses of treatment, sometimes combining them with small forms of surgery. Currently, it is one of the most promising directions of glaucoma treatment, and in some cases allows for partial and improve vision.
In conclusion, it must be said that glaucoma - a lifelong disease. Even if the treatment is carried out allows intraocular pressure to remain at a normal level for many years, there is no guarantee that the IOP rises will not be repeated. Therefore, patients with glaucoma must be kept under the supervision of an ophthalmologist. Typically, the frequency of inspections is every 3-4 months, depending on the stage of the disease.
RISK GROUPS
Age over 40 years.Asians, dark skin, dark hair and the iris.
Heredity (if relatives have glaucoma).
The structural features of the eye (the dark color of the iris, a thin cornea, innate characteristics of the structure of the optic nerve, ocular hypertension - an innate characteristic, in which the intraocular pressure in both eyes is much higher than normal, but it does not lead to damage to the optic nerve).
Chronic inflammation of the eye, "neglected" cataracts.
Long hormonal drugs (corticosteroids), if there is bronchial asthma, diseases of the joints or skin, and others.
Diabetes mellitus and hypertension.
eye injury, which led to a breach of its structure.
Myopia or nearsightedness - such people more likely to develop glaucoma with normal or low blood pressure.
CONTRAINDICATIONS FOR THE OPERATION
severe concomitant diseases of the eye,
if the risk reduction of more than a possible positive effect.
LIST necessary analysis for operations
general analysis of blood, urine,
both.analyze blood (total protein, urea, creatinine, K, Na, blood sugar, bilirubin (fractions),
blood type, Rh factor, blood clotting time (Duke or Sukharev) or coagulation,
HIV, RW, HBs, the HCV, ECG, chest X-ray (photofluorogram), consultation of the therapist, otolaryngologist, dentist.
In diabetes - advice endocrinologist is required.
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