Discover which means glaucoma!
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glaucoma |
Some eye diseases develop quietly, but their result could be a complete loss of vision. Glaucoma - one of the classic examples of such diseases.
Glaucoma is called the chronic eye disease characterized by a significant increase in intraocular pressure. It is extremely important time to reduce the intraocular pressure to normal levels. Otherwise, you may lose the optic nerve. This loss leads to blindness, which can no longer be cured.
According to statistics, it has led to glaucoma blindness about fifteen percent of all blind people in the world. So, it is more than the common disease. The main "risk group" glaucoma - people older than forty years. However, it is often diagnosed at a much earlier age. Even there is a separate concept - Juvenile glaucoma. Moreover, it is not immune from this disease and newborns - and sometimes congenital glaucoma.
The causes of glaucoma
In the event of fault glaucoma intraocular fluid. If violated its excretion, increased the most eye pressure, so - developing glaucoma. Doctors are three main types of the disease - congenital, primary and secondary. Below, we look at each of these types.
Primary glaucoma - the most common type. As already mentioned, more than all the people exposed to it over forty years. Symptoms of glaucoma occur suddenly, without any apparent signs were, in his eyes, seemed perfectly healthy.
Let's look at existing risk factors influencing the occurrence of glaucoma and its progression. These factors can be divided into local and general. Local factors tend to become myopic refraction, more commonly known as nearsightedness. As general factors may make a bad heredity, thyroid disease, or central nervous system and diabetes. In addition to the common factors include advanced age, and - over 60-65 years.
The cause of congenital glaucoma may be an anomaly of eye development in the embryo (called dysgenesis anterior chamber angle) or some other eye disease that is transferred before birth or during them (it can be trauma, tumors, inflammation or something else).
Secondary glaucoma is called, emerged as a result of one of the following eye diseases: cataract, shift (dislocation) of the lens, as well as due to inflammatory (such as keratitis, scleritis, uveitis, and others) and degenerative (exophthalmos effects, progressive atrophy of the iris, etc. ) diseases, as well as after burns and eye injuries, tumors and their surgical procedures.
However, the intraocular pressure can be increased and due to causes of action neglaukomnogo nature. This phenomenon is called hypertensive eyes. The difference between glaucoma and hypertension consists in that the latter comes benign, while not suffering from the disease optic nerve. The cause of hypertension eyes can be a variety of local or general disease, intoxication, age imbalance between the production of intraocular fluid and its outflow, with the endocrine system and a long reception of hormonal preparations, as well as a number of other diseases.
What happens in glaucoma?
Inside our eyes constantly going the process of formation of a special liquid - scientists call it the aqueous humor. The basic amount of water is collected in the front (between the cornea and iris) and back (between the iris and lens) cells of the human eye.
Through a unique drainage system, located at the corner of the anterior chamber, intraocular fluid out of the eye into the bloodstream. Intraocular pressure is determined by the balance between the formation of intraocular moisture and its outflow. Actually, intraocular pressure - a pressure which the contents of the eyeball have on its walls. Typically, the intraocular pressure in a healthy person is in the range of 16 to 22 mm Hg.
If you have glaucoma in the eye of the patient is disturbed circulation of the liquid - it accumulates, because of what begins to grow intraocular pressure. In turn, because of this pressure, the eyeball starts to put pressure on the optic nerve, gradually (quickly enough) destroying it. As a result of these processes in humans begins to deteriorate (or how often people say, "sit down") vision, he begins to see worse. Thereupon come deterioration and more significant problems and symptoms of glaucoma. Disturbed peripheral vision, which is why the zone narrows visibility. If time does not sound the alarm, the eyeball can and do crush the optic nerve. His death comes to total blindness. Modern medicine has not yet found a way to restore vision lost due to the loss of the optic nerve. Vision can just get lost and can - as a result of an acute attack.
Medics
How does glaucoma, what are the symptoms and signs?
The emergence and development of open-angle glaucoma usually pass without any manifestations, imperceptibly for the patient. Any problems or discomfort it causes, and the people - lives in blissful ignorance. There is a narrowing of the field of view, but it's so slow (may take a few years) that the person does not notice the symptoms of glaucoma, and even if the notices - usually write off fatigue or age. Often the patient only accidentally discovers that one eye does not see at all. Approximately every fifth patient notes that he began to see the iridescent circles, looking at the light source (eg a light bulb), many complain of appearing from time to time "fog" or veil before the eyes. Practically, the only symptoms of increased intraocular pressure. Often they are accompanied by a headache and discomfort in the brow area.
In most cases, acute angle glaucoma affects both eyes at once. However, typically, it seems asymmetrically disease. The main symptom of glaucoma - the narrowing of the field of peripheral vision. Typically, it begins by narrowing the nose and then covering the periphery of the field of view up to a complete loss of vision. Many patients notice a dramatic decrease in the ability to see in the evening, at dusk. If you have already started to deteriorate eyesight - the disease is likely to have already started the procedure. The process of atrophy of the optic nerve has already begun. Do something doctors would be extremely difficult.
About a quarter of all cases of primary glaucoma - closure. An indication of such a form is often a pain in the eyes and almost constant discomfort, the pressure in the eye. There are visual disturbances. This and some blurred vision and halos above appearing around lights. Especially noticeable pain in the temples, brow area and side of the head. An acute attack, which we mentioned above, as a rule, is accompanied by closure glaucoma. The reason for this attack - a sharp increase in the eye (intraocular) pressure, which is a symptom of glaucoma.
Typically, such an attack - a direct consequence of a number of trigger factors. These factors may be fatigue, nervous stress, as well as a long stay in the dark or in a position where the head is tilted. Provoke an attack and can receive a one-time large quantity of water, and pupil dilation using drugs.
When an acute attack of pain dramatically manifests itself in the head and eyesight pretty fogged up or drastically reduced, and when looking at the light in front of the eyes appear colored circles. It happens that an acute attack of glaucoma is accompanied by nausea or vomiting, general weakness of the body. Often the pain is given in the abdomen and heart. In such a variety of symptoms lies the main danger - you can easily take an attack of glaucoma for the aggravation of some other diseases (very few people come to mind that the eye disease will have an effect on the heart). As a result - lost time. Meanwhile, this is the case, when the delay - like death. Inescapable blindness can occur within hours after an acute attack.
chapter 2
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.
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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