Glaucoma: symptoms, treatment, and prevention:
Article Content:
- Causes of glaucoma
- Classification of glaucoma
- symptoms of glaucoma
- Diagnosing glaucoma
- glaucoma Treatment
- Prediction and prevention of glaucoma
- Glaucoma - treatment in Moscow
- Glaucoma
To date, no single view of the origins of glaucoma. The true cause of the disease remains a mystery, but it is known that the tendency to increase in intraocular pressure is inherited.
Our reference
Glaucoma - a chronic disease characterized by the continuous or periodic increase in intraocular pressure (IOP) associated with the violation of the outflow of intraocular fluid. Against the background of glaucoma in the future may be optic atrophy, reduction and complete loss of vision.
Perfect vision: to get rid of cataract surgery will forever only
Important
Depending on the degree of disease severity are 4 stages of glaucoma:
At first, a person retained the normal boundaries of the visual field with a small distortion of peripheral vision.
Symptom glaucoma second or advanced stage - expressed disturbances of peripheral vision and overall narrowing of the field of view.
For the third, advanced stage of glaucoma is characterized by the preservation of a certain segment of the field of view.
The fourth stage of glaucoma is characterized by complete blindness.
Test yourself
There are two main forms of glaucoma: open-and-closure. In addition, there are congenital glaucoma, juvenile (child), various forms of secondary glaucoma, including those associated with abnormalities of the eye.
The facts and figures: 60% of patients with glaucoma - people over 60 years
Angle-closure glaucoma manifests itself bouts of severe pain, exciting area of ??the eye sockets, forehead, temple, eye redness, decreased vision, photophobia. Sometimes the symptoms can be so sharp that resemble an attack on cerebral circulation or other acute conditions.
Open-form of glaucoma, which accounts for the majority of all cases of the disease among people of European race, "behave" differently, sometimes for years without giving itself felt. It is no coincidence it was called the "silent." The man, in this case, is normal to feel and not to suspect that stands at the point of no return. In 60% of cases of glaucoma is detected in the "advanced" stages. Hence the confusion in the morbidity statistics. It is believed that in this country of 1 million 200 thousand. Glaucoma patients. But, according to experts, there are much more - about 2 million That is almost 800 thousand patients with glaucoma do not even suspect...
Only one way out - as soon as possible to come and go to an ophthalmologist recommended specialist examination. Since the age of 30, it should be done once a year. Then the doctor will be guidelines, which in the case of glaucoma in a patient to help him choose the right tactics of his treatment and understand what the intraocular pressure for the individual is the best.
Methods of prevention of blindness from glaucoma. The main thing - time to diagnosis
Keep in mind
It is believed that the normal intraocular pressure is in the range 10-23 mmHg. Art. But the absence of elevated intraocular pressure does not mean that there is no glaucoma in humans. There is a particular form of the disease - glaucoma, low or normal intraocular pressure, which for a particular patient is critical. The fact is that the sensitivity of optic nerve fibers to the individual pressure.
Glaucoma can develop at any age. However, it is diagnosed more often in those who crossed the 40-45-year milestone. With age, the percentage of sufferers of this disease is increasing, and it itself for heavier cardiovascular, endocrine diseases (especially - diabetes).
The frequent companion of glaucoma - cataract. This is associated with some similar elements in the development of these diseases. At the "maturation" of cataract formation in the eye of a substance that can block the path of the outflow of intraocular fluid and glaucoma - accumulated metabolic products, which create conditions for the lens opacity.
Even more menacing glaucoma satellite - short-sightedness (myopia). In this case, glaucoma occurs harder and harder to be treated.
Glaucoma: how to "catch" her time and not be blindedInteresting
Many people think that the risk of developing glaucoma is higher in those who suffer from hypertension. In fact, the blood and intraocular pressure are not directly connected. At the heart of glaucoma is a violation of the outflow of intraocular fluid that bathes and nourishes the structure, devoid of blood vessels - the vitreous humor, lens, cornea. In this intraocular pressure increases gradually due to degenerative changes in the eye drainage area.
Glaucoma Treatment:
Glaucoma therapy is usually started with drops that reduce intraocular pressure. When properly selected treatment and ongoing monitoring by a specialist, they can significantly slow the progression of the disease.
In the later stages of glaucoma medication will not last long. Moreover, the intraocular pressure drops occurring between the instillation of drops often themselves are an additional risk factor for worsening of visual functions. Therefore, in such cases, it is necessary to resort to chirurgies
Chapter 2
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 topography, 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:
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 nor molten
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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.
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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