Your vision changes, and you even feel pain in the globes? This could be glaucoma. One million French sufferers, but nearly half know this according to the French Society of Ophthalmology. If not taken in time, glaucoma can lead to blindness.
Article Content:
- Anatomy of the eye
- Early signs of glaucoma
- Glaucoma: a primary screening
- Treatments: evacuate the liquid
- Glaucoma: surgery, the ultimate resort
- Glaucoma: ultrasound treatment
- At the same time, operate with glaucoma and cataract
- Anatomy of the eye
Marina Carrère d'Encausse and Michel Cymes explain glaucoma.
Glaucoma is the leading cause of blindness in France, and one million people suffer from it. Glaucoma is a sneaky eye disease, since it develops most of the time without pain or discomfort, around 45 years, gradually destroying the optic nerve.
When vision is normal, the light rays pass through the cornea, then the iris, the pupil and reach the lens. This lens converges the rays on the retina. The signals are then picked up by the vision cells, the photoreceptors, to be transmitted by the optic nerve to the brain. The space at the front of the cornea is filled with a liquid called aqueous humor. Its role is to nourish and oxygenate the lens and the cornea. It is made by small glands located at the back of the iris.
Once produced, this liquid borrows a specific circuit. It passes through the pupil, fills the space before, then it is evacuated by a natural conduit located in the angle, at the junction point of the iris and the cornea. When this orifice is obstructed, the reabsorption of the liquid is impeded. As a result, it accumulates and the pressure inside the eye increases, this is the beginning of glaucoma.
If the pressure continues to increase, the cells of the eye as well as the optic nerve may be damaged, which will alter the vision (especially the side vision). Without treatment, glaucoma eventually results in total destruction of the optic nerve, causing blindness.
Early signs of glaucoma
Glaucoma is a frequent disease, but it owes its late diagnosis to the absence of pain at the beginning of its development. When the first signs appear it is often too late.
If the pressure increases inside the eye, it can damage the optic nerve, which starts at the back of the eye and transports the images to the brain. As a result, the vision is altered, especially the side vision. The vision "in the middle of the eye" is preserved but it is disturbed all around as if looking into a tunnel.
glaucoma: a primary screening
With advanced imaging tests, glaucoma diagnosis and follow-up are now facilitated
The lifestyle plays an essential role. Have your eyesight checked regularly after 45 years; Avoid tobacco or excess coffee, as they increase the pressure in the eye, and follow the treatment prescribed by your doctor, even if you do not hurt.
Inheritance is also involved, in a proportion of 20% to 30%. Consult at age 40 if a member of your family has glaucoma.
Associated diseases increase the risk. Hypertension, migraines, diabetes or cold hands and feet translate into a vascular risk factor. It is found in 80% to 90% of patients.
Glaucoma is a condition that can be detected during an ophthalmologic examination when the doctor takes eye strain or when he verifies the amplitude of the visual fields. The mean value of the ocular pressure in the population is 15 mm Hg, it is pathological beyond 20.
Glaucoma can, therefore, be detected before the first symptoms appear. It is then possible to delay its evolution.
Examinations allow regular monitoring to assess damage to the optic nerve, and to see if treatment has stopped the destruction of nerve fibers. One of the examinations to determine precisely the involvement of the optic nerve is the OCT or "optical coherence tomography" which allows seeing precisely the state of the nerve fibers in the bottom of the eye.
Treatments: evacuate the liquid
The laser is effective in temporarily reducing ocular pressure.
Glaucoma causes total destruction of the optic nerve and therefore blindness, if not treated in time. If glaucoma is detected early enough, it is known to delay its development efficiently, with eye drops that decrease the amount of liquid in the eye. They must be taken at regular intervals, these medicines are taken for life.
Laser treatment, on the other hand, reduces the production of liquid or facilitates its evacuation. The laser targets the trabecula, a sort of filter that allows the evacuation of the aqueous humor and therefore the reduction of the ocular pressure. This technique is particularly interesting because it is not very painful and does not involve major complications.
However, laser therapy is not suitable for all types of glaucoma. This technique requires that the trabecular be accessible, that is, the ophthalmologists can focus the laser beam on the trabeculae. Laser treatment is therefore only for open-angle glaucoma and can not be performed in the case of glaucoma by closing the angle, where the trabecula is not accessible.
The laser treatment is not final. The effects of the laser fade with time. Patients should have their ocular pressure checked regularly by an ophthalmologist. The latter may then propose a new session if necessary.
Attention, surgical intervention pictures! The aim of the operation is to reduce the intraocular pressure and stop the progression of glaucoma.
If glaucoma is resistant to treatments and the patient's eyesight continues to decrease, surgery may be considered. This involves creating a new liquid evacuation path to maintain normal pressure in the eye. This stops the progression of glaucoma but unfortunately, does not recover lost visual capacities.
Glaucoma: ultrasound treatment
When the treatments by eye drops or laser have failed, ultrasounds can be practiced.
In some cases of refractory glaucoma, when treatments with eye drops or laser have failed, ultrasounds can be practiced.
Ultrasound treatment reduces the secretion of aqueous humor inside the eyeball and reduces the pressure inside the eyeball. Once the eye is disinfected, the ultrasound device is placed on the eyeball, which is then bathed in a conductive liquid. For less than two minutes, the probe sends ultrasound beams.
Ultrasound strikes the eye in six different places. They have the role of coagulating a part of the ciliary bodies which produce the aqueous humor. Its production is thus reduced, the eye pressure decreases.
The advantage of ultrasound treatment is that it is non-invasive. The eyeball is not opened, so there is no risk of infection. The difficulty for the ophthalmologist is to properly dose the amount of ultrasound delivered as explains Dr. Yves Lachkar, ophthalmologist: "If you decrease too much the aqueous humor secretion, it dries up the eyeball and this can cause tension And if not treated sufficiently, the intraocular pressure will not be sufficiently diminished ".
With ultrasound, eye pressure must be reduced by half. Patients should continue to use eye drops and be followed by an ophthalmologist. The use of ultrasound remains reserved for certain types of refractory glaucoma.
At the same time, operate with glaucoma and cataract
Attention, surgical intervention pictures!
How does the combined cataract-glaucoma surgery work?
How does the combined cataract-glaucoma surgery work?
When drug therapy is not enough to stop the progression of glaucoma, surgery can be considered. At the same time, it also makes it possible to treat cataract.
The combined cataract-glaucoma surgery takes place under local anesthesia. The surgeon begins by treating the cataract by replacing the crystalline lens with a synthetic implant. For this, the surgeon uses an injector to compress and position it correctly.
The second stage of the intervention aims to treat glaucoma. In the case of glaucoma, intraocular pressure increases as the trabecular filter between the cornea and the iris are clogged and prevent expulsion of the aqueous humor. Surgery with the insertion of a stent makes it possible to restore the normal path of extraction of the aqueous humor, from the anterior chamber to the extraction channels.
It is by means of a special injector that the stent is positioned very delicately. A difficult exercise where one should not tremble and who requires training to the surgeon. The stent perforates the trabecular
It is by means of a special injector that the stent is positioned very delicately. A difficult exercise where one should not tremble and who requires training to the surgeon. The stent perforates the trabecular filter, allowing the aqueous humor to flow again and lower the intraocular pressure.
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Glaucoma: definition, treatment, symptoms, what is it?
Glaucoma is the second leading cause of blindness after age-related macular degeneration (AMD). More than 70 million people would be hit in the world. Glaucoma can be managed but it can also cause blindness if not detected in time. Back on this disease. What is glaucoma? FacebookTwitter Share on Facebook Glaucoma is an eye disease that affects mostly people over the age of 45 years. Glaucoma is characterized by lesions of the optic nerve. The nerve starts from the retina at the back of the eye and carries the images to the brain.
When this nerve is damaged the visual field is reduced, the vision is then altered and can lead to blindness in the long term. It is a progressive disease, which can have no symptoms for a long time but there are several types of glaucoma:
- Chronic open angle glaucoma: this is the most common form of the disease (90% of cases ).
It is caused by the gradual closure of the aqueous humor evacuation filter. In this case, the alteration of vision is slow and painless, causing no discomfort at first, making its diagnosis difficult.
- Closed-angle glaucoma (acute glaucoma): it is due to an anomaly of the anatomy of the eye which prevents the evacuation of the aqueous humor through the trabecular, remaining blocked in particular behind the iris.
The pressure inside the eye then increases strongly. The symptoms of closed-angle glaucoma are characteristic. As soon as they appear, glaucoma should be treated urgently to avoid blindness. - Secondary glaucoma: they are caused by trauma like the shock to the eye or by an inflammatory or congenital disease. Causes: What Causes Glaucoma? In most cases, glaucoma is linked to an increased pressure inside the eye, also called intraocular hypertension.
For information, a liquid is produced permanently inside the eye, it is the aqueous humor. This is evacuated via a filter located at the angle between the iris and the cornea, called trabeculae. When the evacuation of this liquid is obstructed, the pressure inside the eyeball increases abnormally and causes an alteration of the fibers of the optic nerves. There are several risk factors for this disease. Increased intraocular pressure (above 21 mm Hg) is the main factor in glaucoma. However, hypertension (or hypertension) does not necessarily lead to glaucoma, and conversely, glaucoma with intraocular pressure exists within normal limits. A second measure is an age. Glaucoma usually occurs in people over 40 years of age, and its frequency increases with the years. Glaucoma is also hereditary, ie the risk increases when a parent is affected. Finally, myopia is also a risk factor. Symptoms: how to detect glaucoma? Since glaucoma evolves silently in most of the time,
When this nerve is damaged the visual field is reduced, the vision is then altered and can lead to blindness in the long term. It is a progressive disease, which can have no symptoms for a long time but there are several types of glaucoma:
- Chronic open angle glaucoma: this is the most common form of the disease (90% of cases ).
It is caused by the gradual closure of the aqueous humor evacuation filter. In this case, the alteration of vision is slow and painless, causing no discomfort at first, making its diagnosis difficult.
- Closed-angle glaucoma (acute glaucoma): it is due to an anomaly of the anatomy of the eye which prevents the evacuation of the aqueous humor through the trabecular, remaining blocked in particular behind the iris.
The pressure inside the eye then increases strongly. The symptoms of closed-angle glaucoma are characteristic. As soon as they appear, glaucoma should be treated urgently to avoid blindness. - Secondary glaucoma: they are caused by trauma like the shock to the eye or by an inflammatory or congenital disease. Causes: What Causes Glaucoma? In most cases, glaucoma is linked to an increased pressure inside the eye, also called intraocular hypertension.
For information, a liquid is produced permanently inside the eye, it is the aqueous humor. This is evacuated via a filter located at the angle between the iris and the cornea, called trabeculae. When the evacuation of this liquid is obstructed, the pressure inside the eyeball increases abnormally and causes an alteration of the fibers of the optic nerves. There are several risk factors for this disease. Increased intraocular pressure (above 21 mm Hg) is the main factor in glaucoma. However, hypertension (or hypertension) does not necessarily lead to glaucoma, and conversely, glaucoma with intraocular pressure exists within normal limits. A second measure is an age. Glaucoma usually occurs in people over 40 years of age, and its frequency increases with the years. Glaucoma is also hereditary, ie the risk increases when a parent is affected. Finally, myopia is also a risk factor. Symptoms: how to detect glaucoma? Since glaucoma evolves silently in most of the time,
It is only at an advanced stage that the symptoms are felt. Symptoms differ depending on the type of Glaucoma. Glaucoma with open angle (usually affects both eyes): - absence of symptoms for 10-12 years - disturbed peripheral vision - possibly eye pain and headache Glaucoma with a closed angle (usually affects only one eye): - strong Eye pain - blurred vision - vision of colored halos around light sources - reddening of eyes - nausea or vomiting Congenital glaucoma: - large, often watery eyes - irises with fuzzy details - strong sensitivity to light Symptoms may appear a few months after the birth. Treatment: how to treat glaucoma? Unfortunately, there is no curative treatment for glaucoma and the lost acuity can not be recovered.
The treatment of glaucoma is to prevent or slow down its development and subsequent damage by improving the circulation of the aqueous humor, which will decrease the pressure inside the eye. There are three categories of treatment. - medication treatments Ophthalmic drops reduce the pressure in the eye. They are preferred to oral medications because they cause fewer side effects. Beta-blockers, alpha-adrenergic agents, prostaglandin analogs, carbonic anhydrase inhibitors, and mystic drugs are available. Most reduce the production of aqueous humor by increasing its excretion (elimination). This treatment is very effective if the dosage is respected, and it is taken for life without interruption. It may, however, have side effects, talk to your doctor. - the laser When the drug treatments no longer work, a laser treatment can be proposed. It facilitates the evacuation of the aqueous humor. Since the results are generally not final, it may be necessary to reinforce or resume treatment with eye drops a few months or a few years later.
- surgery In the case where Glaucoma is resistant to previous treatments and the eyesight continues to fall, glaucoma may be operated in ambulatory care. The operation involves creating a new way of evaluating the aqueous humor to maintain normal pressure in the eye. Even if it stops the progression of glaucoma, it does not recover lost visual capacities. It should be noted that all treatments of glaucoma increase the risk of developing a cataract (loss of transparency of the lens) and especially surgical treatments.
The treatment of glaucoma is to prevent or slow down its development and subsequent damage by improving the circulation of the aqueous humor, which will decrease the pressure inside the eye. There are three categories of treatment. - medication treatments Ophthalmic drops reduce the pressure in the eye. They are preferred to oral medications because they cause fewer side effects. Beta-blockers, alpha-adrenergic agents, prostaglandin analogs, carbonic anhydrase inhibitors, and mystic drugs are available. Most reduce the production of aqueous humor by increasing its excretion (elimination). This treatment is very effective if the dosage is respected, and it is taken for life without interruption. It may, however, have side effects, talk to your doctor. - the laser When the drug treatments no longer work, a laser treatment can be proposed. It facilitates the evacuation of the aqueous humor. Since the results are generally not final, it may be necessary to reinforce or resume treatment with eye drops a few months or a few years later.
- surgery In the case where Glaucoma is resistant to previous treatments and the eyesight continues to fall, glaucoma may be operated in ambulatory care. The operation involves creating a new way of evaluating the aqueous humor to maintain normal pressure in the eye. Even if it stops the progression of glaucoma, it does not recover lost visual capacities. It should be noted that all treatments of glaucoma increase the risk of developing a cataract (loss of transparency of the lens) and especially surgical treatments.
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