Discover The bottom line in glaucoma surgery!
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glaucoma surgery |
- Causes of glaucoma
- Classification of glaucoma
- symptoms of glaucoma
- Diagnosing glaucoma
- glaucoma Treatment
- Prediction and prevention of glaucoma
- Glaucoma - treatment in Moscow
- Glaucoma
Glaucoma - a chronic pathology of the eye characterized by increased intraocular pressure, the development of optic neuropathy and impaired visual function. Clinically manifest glaucoma visual field loss, pain, sharp pain and feeling of heaviness in the eyes, blurred vision, twilight vision deterioration, in severe cases, blindness. Diagnosing glaucoma includes perimetry, tonometry, and tomography, gonioscopy, optical coherence tomography, laser retinotomografiyu. Glaucoma treatment requires the use of glaucoma drops, application of laser surgery techniques (iridotomy (iridectomy) and trabeculoplasty) or of antiglaukomatoznyh operations (trabeculectomy, splenectomy, iridectomy, iridotsikloretraktsii et al.).
Causes of glaucoma
Classification of glaucoma
symptoms of glaucoma
Diagnosing glaucoma
glaucoma Treatment
Prediction and prevention of glaucoma
Glaucoma - treatment in Moscow
Glaucoma
Glaucoma - one of the most feared diseases of the eye, leading to vision loss. According to available data, glaucoma affects about 3% of the population and 15% of blind people in the world was the cause of all glaucoma blindness. The risk of developing glaucoma are people over 40 years, but in ophthalmology are such forms of the disease, as a young adult and congenital glaucoma. The incidence increases significantly with age: for example, congenital glaucoma is diagnosed in 1 out of 10-20 thousand newborns;. in 40-45-year-old group of people - in 0.1% of cases; 50-60-year-olds - in 1.5% of cases; after 75 years - more than 3% of cases.
Under glaucoma understand chronic eye disease, occurring with periodic or permanent increase in IOP (intraocular pressure), disorders outflow IOF (intraocular fluid), trophic disorders of the retina and the optic nerve, which is accompanied by the development of visual field defects and the edge of excavation of the optic disk (optic nerve) . The term "glaucoma" now bring together about 60 different diseases that have these features.
Causes of glaucoma Surgery:
Studying the mechanisms of development of glaucoma suggests a multifactorial nature of the disease and the role of a threshold effect in its occurrence. That is, for the occurrence of glaucoma requires a number of factors, which together cause the disease.Pathogenetic mechanisms of glaucoma associated with the violation of the outflow of intraocular fluid, which plays a key role in the metabolism of all structures of the eye and maintaining normal IOP. Normally produced by the ciliary (ciliary) body of aqueous humor accumulates in the posterior chamber of the eye - the slot-like space located behind the iris. 85-95% IOF flows through the pupil into the anterior chamber of the eye - the space between the iris and the cornea. The outflow of intraocular fluid is provided by a special drainage system of the eye, located at the corner of the anterior chamber and formed trabecular and Schlemm's canal (venous sinus of the sclera). Through these structures, IOF flows off into the scleral veins. A small part of the aqueous humor (5-15%) flows off additional use scleral by seeping through the ciliary body and sclera in the venous reservoirs of the choroid.
In order to maintain normal intraocular pressure (18-26 mm Hg. Art.) Requires a balance between the inflow and outflow of aqueous humor. In glaucoma, this equilibrium is disrupted, resulting in the eye cavity accumulates an excess amount of IOF, which is accompanied by an increase in intraocular pressure above the tolerance level. High IOP, in turn, leads to hypoxia and ischemia of the eye tissue; compression gradual degeneration and destruction of nerve fibers, the retinal ganglion cell disintegration and eventually - the development of glaucomatous optic neuropathy and optic nerve atrophy.
The development of congenital glaucoma is usually associated with abnormalities of the eyes in the fetus (dysgenesis of the anterior chamber angle), trauma, eye tumors. Predisposition to the development of glaucoma has acquired in individuals with family history of the disease, those suffering from atherosclerosis and diabetes, hypertension, cervical osteochondrosis. In addition, secondary glaucoma can develop as a result of other diseases of the eye: farsightedness, occlusion of the central retinal vein, cataract, scleritis, keratitis, uveitis, iridocyclitis, progressive atrophy of the iris, exophthalmos, wounds and eye burns, tumors, surgery on the eyes.
Classification of glaucoma:
By origin distinguish primary glaucoma, as an independent pathology of the anterior chamber, the drainage system, and optic disc, and secondary glaucoma is a complication of extra- and intraocular disorders.
In accordance with the mechanism underlying the increase in IOP, release-closure glaucoma and open-primary. In angle-closure glaucoma is an internal block in the drainage system of the eye; in open form - the angle of the anterior chamber is open, but IOF outflow broken.
Depending on the level of IOP in glaucoma can occur norm often
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glaucoma:
Glaucoma is one of the most frequent causes of irreversible vision loss in the world. This is a complex group of diseases that are usually slowly over several years without developing any symptoms. At the beginning of the disease the patient may not even notice that something is wrong, because it is usually the first manifestations are the loss in the outer (peripheral) region of the field of view. This pattern is typical of the most common forms of the disease - open-angle glaucoma. By the time the loss of visual field becomes noticeable to the patient, as a rule, it is a sign that the disease has gone far enough. In this case, do not delay, contact an ophthalmologist, because, in the absence of adequate treatment, glaucoma can lead to significant loss of vision and even blindness.
Although glaucoma usually affects both eyes, it can be expressed in them at different degrees. In this case for some time, at least the damaged eye can compensate for vision, lost the more affected eye.
What is it?
In glaucoma, the optic nerve is damaged, located in the posterior pole of the eyeball and the connecting eye to the brain. In this disease there is a slowly progressive deterioration of the nerve fibers, extending from the retina, which in the absence of adequate treatment leads to the appearance of defects in the field of view, and even blindness. Causes of glaucoma are not well enough known. Very often the loss occurs at elevated intraocular pressure (IOP). High IOP - a major risk factor for developing glaucoma. In turn, the IOP rises when, for one reason or another, hindered outflow of aqueous humor from the eye - constantly produces fluid that fills the space between the cornea and the lens, and the supply last. There are at least 50 different types of glaucoma, but the most common so-called primary open-angle glaucoma. Most often, glaucoma occurs in the elderly (over 60 years). The exception is congenital glaucoma and some secondary forms of glaucoma (glaucoma, which developed as a result of other diseases).
Drugs used to treat patients with glaucoma:
Kosopt®
Taflotan®
Trusopt®
Oftan® timolol
Oftan® Ti model
Fotil® / Fotil® Forte
Risk factors
The most significant risk factors for glaucoma include:
The high intraocular pressure (IOP) within the eye increases the pressure, if for some reason difficult outflow of aqueous humor from the eye.
Intraocular pressure depends on many factors and can vary from hour to hour, be different on different days or weeks. Various techniques are used to measure IOP: in domestic ophthalmology mainly used Maklakov IOP measurement using special weights; foreign ophthalmologists often used by Goldmann. In addition, screening for glaucoma in some cases non-contact tonometry method can be applied. Measurement of IOP is painless and takes only a few seconds. For "normal" IOP Maklakov assumed pressure in the range 15-25 mm Hg (millimeters of mercury - intraocular pressure measurement unit). As measured by a Goldmann digits "normal" IOP slightly below: 10-21 mmHg. Moderately elevated IOP (22-30 mmHg by Goldmann) does not necessarily lead to any defects in the visual field. However, if the IOP is greater than 30 mm Hg, the risk of developing glaucoma grows 40 times. In general, the higher the pressure, the greater the risk of damage to the optic nerve. However, in some patients with glaucoma IOP does not exceed 21 mm Hg (Normal pressure glaucoma). In other words, the so-called intraocular pressure tolerant, i.e. IOP to which the stability of the structure of the optic nerve, these patients have lower rates and depends on the individual.
Age: 10 years of life every double the risk of developing glaucoma (a disease is most common among the elderly over 60 years and is rare before the age of 40 years).
Heredity: if glaucoma in close relatives the risk of developing glaucoma increases in 3-9 times.
Exfoliative syndrome: degeneration of the iris and ciliary body combined with exfoliation (desquamation) of the epithelium of the lens capsule. It is characterized by the formation of flaky layers of light-gray color on the anterior capsule of the lens, ciliary body, the iris. Quite often observed in elderly and senile age is widespread in the Nordic countries, in the North-West region of Russia and others. Regions.
Myopia (short-sightedness): in patients with myopia above three diopters the risk of glaucoma increases 2-3 times.
Race in people of African and Afro-Caribbean origin risk of developing glaucoma is 5-6 times higher than that of Caucasians.
Associated diseases: diabetes, atherosclerosis, and hypertension (high blood pressure) can lead to poor blood flow in the eye and Development Mr.
glaucoma treatment
Treatment of patients with glaucoma should first be directed to the normalization (decrease) in IOP. The goal of treatment - to stop the progression of the disease and keep those visual features that are available at the time of treatment to the doctor. Unfortunately, already lost vision can not be restored in glaucoma. If the pressure is high, but there are no signs of glaucoma, it is possible to restrict the observation without treatment or start prophylactic treatment. About what treatment to appoint, ophthalmologist always decides individually.
The choice of method of IOP reduction depends on many factors. Typically, glaucoma therapy step: treatment begins with medical therapy; with its lack of effectiveness of the laser treatment is performed, and if it is not enough, then the surgery. The operation and the reduction of IOP after it, however, does not mean that the patient got rid of glaucoma. Glaucoma life requires constant observation and treatment.
There are various preparations (eyedrops) for lowering IOP: some decrease aqueous humor production (such as beta-blockers such as timolol or Oftan® Oftan® Ti model) increase its other outflow (e.g., prostaglandin analogs such as Taflotan®) others have a combined mechanism of action (Fotil®, Fotil® forte). Conservative treatment is always selected individually, taking into account the patient's age and comorbidities. Treatment should be continued throughout the patient's life. It is, therefore, important that the drug has an optimal tolerability, and prescribing physician was easy and convenient to carry. It is essential that medicines used in strict accordance with the prescription of an ophthalmologist, as they can only be effective when used correctly. For long-term use of eye drops preferably without preservatives for optimum treatment tolerability.
The laser treatment (laser trabeculoplasty) can be used as an alternative. The goal of laser trabeculoplasty - improve the outflow of aqueous humor from the eye and thereby reduce IOP. This technique helps to reduce the pressure by at least a few years. If glaucoma progresses despite medical therapy and laser treatment, surgery may be assigned.
The most common surgery for glaucoma is the trabeculectomy. This procedure is aimed at reducing intraocular pressure by removing a portion of the trabecular meshwork and ensuring the outflow of aqueous humor under the conjunctiva. Other modifications designed and glaucoma surgery, also has the purpose to improve the outflow of aqueous humor, but their results are not always constant. Additionally, any penetration of the eye cavity - the risk of infection and the development of lens opacity (cataract) thereafter.
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glaucoma treatment :
How to treat glaucoma eye and preserve vision
Vision helps us to perceive the outside world in the fullness of his points. But not everyone properly belongs to his eyes. Many people forget about caring and care attitude often leads to complications or even worse, the loss of the ability to see and perceive the world.
Glaucoma is one of the worst diseases of the eye in our time. This is due to the fact that the man not only loses sight but also suffering from elevated intraocular pressure.
In spite of the severe symptoms of the disease, glaucoma still treated not only medication but also to traditional methods.
Glaucoma is called cataract eye. Shades of cloud often whitish with a blue or light green shade. In this disease in humans is reduced sharply rises vision and intraocular pressure, which leads to strong discomfort.
Rise intraocular pressure may itself, or as a result of postponed or time has not eliminated the disease. As a result of glaucoma in humans suffering from the optic nerve. If you do not begin to treat disease in time, it will contribute to the full, unrecoverable loss of vision.
Intraocular fluid circulates poorly, which causes all boolean.Chase this disease occurs in the elderly and people over 40. However, glaucoma is the teenage and even innate. Sometimes glaucoma affects both eyes and is almost at the same time. The disease is chronic.
Symptoms of the disease
In time to realize that vision problem are caused by glaucoma, it is necessary to know the three main symptoms of this disease. The main signs of glaucoma are:
change and deformation of the optic nerve;
high, excessive pressure within the eye;
impaired vision, the viewing restriction.
How to recognize the increased intraocular pressure? There are several factors that speak about the pressure on the eyeball:
slight pain around the eyes;
poor ability to see in the dark;
feeling over-moist eyes;
cutting sensation;
appearance hazy effect in the concentration.
Glaucoma can occur abruptly, to develop a strong attack. With this attack, the patient arises cutting pain in the eyeballs, which, after moves to eyebrows, Vicki, ears and can be accompanied by nausea and vomiting. But the disease can develop gradually.
Preparations for the treatment of glaucoma eye
At the initial stage of the disease, specialists use drugs which contribute to the normalization of intraocular pressure in normal blood supply to support the inner shell eyes.
Primary glaucoma occurs in the following forms:
Open-;
closure;
Mixed.
Pilocarpine - drops for glaucoma treatment
angle-closure glaucoma treatment
During the treatment of angle-closure glaucoma drops are used, which are able to narrow the pupil of the eye and cause spasm of the ciliary muscle. This helps to disclose the anterior chamber angle, promotes uniform outflow of moisture, however, it causes a blurred vision.
These medications include:
2.1% pilocarpine solutions;
carbachol solutions izopto- 1.5-3%;
pilokaprina hydrochloride solutions with 1% methylcellulose.
These medicines help to alleviate the short-term since the angle-closure glaucoma optic atrophy occurs much faster.
Patients with this form of the disease are often necessary to resort to surgery.
Administered in operation, if none of the drugs did bring relief and increased intraocular pressure suspended.
Timolol - eye drops
Treatment of open angle glaucoma
Patients with open-angle glaucoma are necessary to achieve the elimination of excessive moisture through the trabecular meshwork. The main task, which will contribute to a speedy recovery dynamics, is the selection of essential drugs, which include:
- ti mop tika solutions of 0.25% and 0.5%;
- Timo PTI ka depot;
- often-timolol solution of 0.25% and 0.5%;
- Betaxolol hydrochloride solution;
- suspension Betoptic -S 0,25%;
- Xalatan 0.005% solution;
- Travatan solution of 0, 004%.
- The above solutions are contraindicated for people suffering from heart failure, asthma, disorders of the heart.
- All drugs in this series exclude the possibility of increasing the volume of the pupil, as well as accommodation.
Drugs with combined action prescribed glaucoma patients with mixed forms of manifestation.
trusopta 2% solution;
Azopt 2% solution.
Surgical glaucoma treatment
In the early stages of the disease, ophthalmologists recommend laser treatment of glaucoma. The operation is performed under local anesthesia and does not require hospitalization. However, in more recent and severe cases, doctors have to resort to surgery.
There are several ways by which the disease is eliminated surgically:
trabeculectomy
This surgery allows you to create new channels of drainage of aqueous humor from the anterior chamber of the eye under the conjunctiva. Thus, alternative ways of fluid withdrawal, in consequence of which decreases pressure on the eyeball.
This technique is used most often and is used for the treatment of almost all forms of glaucoma, but as with any surgery can cause complications pleased. Postoperative scars can become chronic, and glaucoma and loss of vision back to the previous stage.
sclerotic ectomy
The advantage of this fairly widespread operation is that the natural mechanisms of the outflow of excess fluid are not violated. The fluid pressure inside the eye drops to the required performance.
Unlike trabeculectomy with this surgery, there are no blockade artificial aqueous humor outflow pathways by means of scarring that often occurs in young people.
In carrying out such an operation, it is possible to use and other surgical procedures in the aftermath. There is also no risk of infection and vascular sheath detachments.
colectomy:
This surgery, in which the surgeon removes the pupillary block and creates a parallel path of the outflow of aqueous humor from the posterior to the anterior chamber.
The result of this procedure will be different in pressure equalization chamber of the eye and eliminate the discomfort, pain and blurred vision.
treatment of cataract without surgery at an early stage of cataract alone can be treated without surgery traditional methods.
Preparations for the treatment of viral conjunctivitis in children, see this article.
Glaucoma Treatment folk remedies
Eyewash. Calendula Flowers are one of the most popular tools in the treatment of glaucoma. This infusion is used for rinsing the eyes and as a lotion for the night. 3 teaspoons of calendula flowers filled with hot water. The broth should stand for two hours, wrapped in thick cloth. Broth strain and drink inside 3-4 times a day. The same infusion, flush the eye.
To reduce the pressure. It is necessary to take 3 tablespoons of crushed dried leaves of walnut, wild rose 2 teaspoons flowers, 1 teaspoon of the root and rose hips a little piece of leaf aloe. All ingredients pour 500 ml. of boiling water and let stand for an hour. The solution must drain and drink one tablespoon per day before meals.
To compress on the eyes. A half cup of chopped nettles mixed with pulverized flowers, lily of the valley. In this recipe, use only fresh plants, as they contribute to a speedy recovery. Collection must be carefully ground and add to it 1 tablespoon of water. The mixture was infused for 10 hours. Use as a compress on the eyes.
For slowing down the development of glaucoma. 1 tablespoon ginger, licorice, flowers motherwort, buckwheat, and lemon balm to alter and filled with boiling water. Infused tax 1 hour. Ingest at half cup 2 times a day. The course of treatment lasts for one month, then you need to take a break for a while and repeat the treatment again.
Glaucoma treatment extremely difficult and painstaking process.
The total course of treatment comprises the maintenance of normal intraocular pressure. This state is maintained by using diuretics, cardiovascular drugs, special eye drops. The course of treatment drugs must first be discussed with your doctor.
Note that the advanced stage of the disease will inevitably lead to blindness. The sooner people seek proper help, the more successful will take the entire course of treatment. Status glaucoma relies entirely on your lifestyle and on compliance with the doctor's recommendations of your data.
First, patients must avoid glaucoma nervous disorders, stress and excessive exercise.
It is advisable and compliance with a balanced diet, in which plant components will be included. Eating fried and fatty foods should be deleted.
To date, there is no true techniques and methods that can accurately prevent the development of this disease. But hardly suspected at the first symptoms of glaucoma, is urgently needed, not seconds without delay to consult a specialist.
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