Causes of glaucoma and approaches to treating the disease

Most people are asymptomatic until severe vision problems develop.

The first complaint of patients is usually loss of peripheral vision, which often goes unaddressed, and the disease continues to progress.

 In some cases, people may complain of decreased vision in the dark, the appearance of rainbow circles, and headaches. Sometimes it is noted that one eye sees, the other does not.

Glaucoma is characterized by three main symptoms:

1. increased intraocular pressure;
2. narrowing of the field of view;
3. change in the optic nerve.

The field of vision may be narrowed, so-called tunnel vision appears, which can develop to the point of complete loss of vision. An acute attack is accompanied by sharp pain in the eye, in the forehead, deterioration of the general condition, nausea, and vomiting.

In order to recognize glaucoma in time, it is important to know its symptoms and the patient’s subjective feelings

Types of glaucoma of the eye	Symptoms
Open angle	The clinical course of open-angle glaucoma is usually asymptomatic. The narrowing of the visual field develops gradually, sometimes progressing over several years, so patients often accidentally discover that they see with only one eye. The following signs that appear regularly or from time to time should be on your guard: feeling of discomfort in the eyes, tension, tightness; slight pain in the eye sockets; pain in the eyes; lacrimation; redness of the eyes; blurred vision at dusk and darkness; the appearance of rainbow halos when looking at a light source; blurred vision, the appearance of a “mesh” before the eyes.
Closed angle	Often occurs in the form of attacks. An acute attack of this form of glaucoma has characteristic symptoms: significant increase in IOP (up to 60-80 mm Hg), severe pain in the eye, headache. Often during an attack the following may appear: nausea, vomit, general weakness. Vision in the affected eye drops sharply. An acute attack of angle-closure glaucoma is often mistaken for a migraine, toothache, acute stomach disease, meningitis, or influenza, because the patient complains of headache, nausea, and general weakness, without mentioning the eye.

Both types of glaucoma can cause blindness by damaging the optic nerve; however, with early detection and treatment, intraocular pressure can be controlled and severe vision loss can be prevented.

Symptoms of the initial stage of glaucoma

But, nevertheless, there are a number of signs of increased pressure inside the eye. The first symptoms cannot diagnose the disease. They only signal problems with intraocular pressure. Having received these signals, a person should immediately go to an ophthalmologist. After conducting an examination and prescribing additional examinations, the doctor will confirm or refute your concerns.

What are the main signs of increased intraocular pressure? There are five of them:

• the appearance of a feeling of discomfort in the eye area;
• false sensation of eye moisture;
• blurred eyes;
• violation of the mechanism of light perception at night (decreased ability to see objects in the dark);
• the appearance of “rainbow circles” before the eyes.

The following signs may also indicate increased fluid pressure inside the eyes:

• feeling of heaviness;
• slight pain in the eyes;
• feeling of slight pain around the eye.

Signs that may be confusing

By the way, rainbow circles, being the most “intelligible” of the first signs listed above, may indicate not only a developing eye disease, but also other painful conditions or ailments. Unfortunately, often no less serious.

Such diseases include:

• illnesses associated with disruption of the vascular system inside the brain;
• diabetes (in this case, the appearance of “rainbow circles” before the eyes is temporary);
• mechanical damage (trauma) to the eye, face, and temporal part of the head.

The fact that a “rainbow” before the eyes is a “bell” of a disease called “glaucoma” can be understood as follows. Circles do not appear suddenly, but after a person looks for some time at a glowing light bulb under a floor lamp, fire or another, not too aggressive light source.

If “rainbow circles” are indeed symptoms of a “light blue tumor,” then they can be used to determine the severity of the disease. Pale circles are symptoms of the disease in the early stages. The brighter ones indicate the neglect of the case.

Walking in pairs: paired companions of diseases

If you notice that something is wrong with your eyes, do not rush to blame “glaucoma”. Carefully monitor which symptom was paired with the one that frightened you.

For example, the appearance of a sharp headache along with the aforementioned “rainbow” is an encouraging sign. This is a clear companion to migraine. If you “choose the lesser of two evils,” then migraine will turn out to be the lesser evil. Once the migraine attack passes, the “rainbow” will disappear.

Circles together with double vision can be symptoms of a very dangerous condition. But it has nothing to do with glaucoma. The definitions of these conditions are in the field of neurology.

In more serious cases, they may indicate hallucinations that occur due to medications, alcohol, or drugs taken.

In this case, magnetic resonance imaging will help determine the cause of the patient’s condition.

If your diagnosis is cataract

Clouding of the lens of the eyeball, which is a living lens, is called a cataract by doctors. Most often, cataracts can be found in older people; it occurs much less often in young people and adolescents.

Master of Traditional Medicine, Vice-Rector of Otochmanramba University at Manbadatsan, Professor Odontsetseg says that treatment should be carried out together with the treatment of cervical osteochondrosis, which affects the vast majority of people with mental work and almost everyone sitting at a computer. These eye diseases are caused both by excessive strain on the organs of vision and as a consequence of cervical osteochondrosis.

Nutrition

If glaucoma is diagnosed, you should also reconsider your diet and nutrition system, as this also affects the course of the pathological process.

Properly selected products will slow down its progression, while ignoring simple requirements can speed it up. In principle, there are few dietary restrictions, and if it is balanced, they will be almost invisible.

Basically, foods that are not healthy for a healthy person are prohibited. By eliminating them, you can achieve a noticeable improvement in overall health.

So, if you have glaucoma, you should exclude it from your diet.

• fatty foods
• smoked meats
• spicy dishes
• a large number of sweets and confectionery products
• strong tea and coffee

Also limit your intake of sugar and salt.

The patient also needs to adhere to the drinking regime. In summer, this should be at least 2 liters of water per day; in winter, less is acceptable.

Alcohol and smoking

Alcoholic drinks for glaucoma are absolutely contraindicated, even very weak ones - alcohol contributes to the narrowing of blood vessels, which means an increase in pressure, both arterial and intraocular.

So glaucoma and alcohol are absolutely incompatible. The same applies to smoking. Both of these habits also lead to toxic damage to the optic nerve and its atrophy.

They significantly accelerate all pathological processes in the eyeball.

Smoking hookahs and electronic cigarettes lead to the same results.

Medicines

With glaucoma, there are a number of prohibitions when taking medications. Some of them can seriously complicate the course of the disease and cause its exacerbation. When prescribing them, it is necessary to notify your doctor about the presence of glaucoma in order to replace such drugs with their analogues or even use physiotherapeutic methods or herbal medicine.

• Prohibited medications include
• Medicines that are used for anesthesia - some of them help to increase eye pressure; various sulfodrugs - when used, the angle of the anterior chamber narrows, resulting in swelling of the lens and an increase in intraocular pressure; many antispasmodics and antihistamines, which cause dilation of the pupil, should be used with caution aspirin
• female oral contraceptives - changes in hormonal levels have a bad effect on eye pressure.

Glaucoma Treatment Methods

Of course, glaucoma and its consequences cannot be completely eliminated. However, it is possible to maintain normal eye function for a long time. There are two main approaches:

• Conservative therapy. In this case, the patient must regularly instill solutions to reduce the level of intraocular pressure. The mechanism of action of drugs is associated with improving the outflow of fluid or inhibiting its production. Conservative therapy is effective in the early stages of glaucoma, but when medications are discontinued, intraocular hypertension returns and the disease worsens. In this regard, it is impossible to get rid of glaucoma with the help of medications. In addition, the effectiveness of drops is higher in open-angle glaucoma, that is, in the case when there are no structural changes inside the eyeball. The closed-angle form of glaucoma is practically not amenable to conservative therapy.
• Surgical approach to the treatment of glaucoma. It is justified to use it in the later stages of the pathological process, as well as in closed-angle glaucoma. The effectiveness of the operation is due to the fact that as a result, structural abnormalities in the eye are eliminated. This leads to normalization of the outflow of aqueous humor and elimination of intraocular hypertension. During surgery, the doctor creates new pathways for the outflow of intraocular fluid. It is worth noting that even after radical surgery, glaucoma can recur.

Laser surgery for the treatment of glaucoma became popular in the seventies of the last century. The purpose of the operation is to eliminate structural blocks in the outflow of aqueous humor.

To carry out the intervention, semiconductor, argon, and neodymium laser units are used, with which the doctor makes small holes in the trabecular meshwork.

After the formation of scar tissue, these holes turn into full-fledged new outflow pathways for intraocular fluid.

The advantages of laser surgery for the treatment of glaucoma are:

• Removing the blockage for the outflow of aqueous humor;
• No postoperative complications;
• Reduced recovery period.

However, laser surgery cannot be called a panacea against glaucoma, since this type of intervention also has disadvantages:

• Limited effect after surgery, which decreases over time, that is, it is most advisable to perform laser surgery in the early stages of glaucoma development;
• Relatively high risk of damage to intraocular structures (cornea, iris, lens);
• The possibility of developing a reactive syndrome, when there is a sharp increase in intraocular pressure and the development of inflammation in the postoperative period.

Other initial signs in the early stages

There are 5 stages of development of the disease “glaucoma”:

• I – initial;
• II – developed;
• III – highly developed;
• IV – almost absolute;
• V – absolute.

Symptoms of a “light blue tumor” in the early stages (initial and advanced) depend on its forms and types.

The disease can be primary or secondary. Why primary glaucoma develops is still unknown to science. As for the secondary form, scientists have found that it develops as a result of complications of a number of intraocular diseases.

1. If we talk about the primary form of the disease, there are two types:
2. The sensations of a patient with glaucoma in the first stage vary depending on whether it is simple or congestive.
3. Congestive glaucoma is characterized by:

• blurred and painful eyes;
• dilated pupils;
• a condition when a person sees the notorious “rainbow circles” in the form of a halo around household, even weak, light sources.

But simple glaucoma turns out to be the most insidious. For two to three months the disease proceeds without external manifestations or specific symptoms. This type of disease can only be detected during examination by an ophthalmologist.

When diagnosing a simple type of illness, the doctor diagnoses a decrease in the field and decreased vision only in later stages. But the first symptoms of glaucoma at an early stage are difficult even for a doctor to determine. To make a diagnosis, he identifies changes in the so-called fine visual functions.

Thus, an examination to identify the first symptoms in the early stages of the disease “simple glaucoma”, as a rule, includes the following set of diagnostic measures:

• computer measurement of field of view;
• refractive examination;
• Ultrasound of the eyeball;
• study of intraocular pressure (IOP);
• measurement of lens parameters (an increase in its thickness indicates increased IOP);
• study of the pathways of fluid outflow from the eye.

At an early stage of a simple form, the disease is determined only with the help of modern computerized equipment

It is important to consult a doctor promptly

Glaucoma: risk factors

Who is at risk, who needs to undergo specialized examinations by an ophthalmologist more often than others to identify a dangerous disease, the outcome of which, if not treated in a timely manner, is blindness?

The first risk factors include:

• Unfavorable heredity. People who have relatives diagnosed with glaucoma suffer from this eye disease two to three times more often than their peers.
• Myopia. Patients with moderate (or higher) myopia are at risk of developing glaucoma 3 times more than other people in their age group.
• Accompanying illnesses. Intraocular pressure is the first cause of "light blue tumor". Increased IOP is caused by diseases: arterial hypertension, atherosclerosis of the extremities, diabetes mellitus.
• Mature and old age. After forty years, in every subsequent ten years of life, the risk of being diagnosed with glaucoma doubles!
• Color of the skin. The race factor increases the risk of developing a dangerous eye disease five times! Moreover, white-skinned people are the winners. Patients with ophthalmologists often become patients with dark skin (indigenous inhabitants of Africa).

Glaucoma: surgery cannot be avoided

Where to put a comma in this sentence—before or after the word “impossible”—depends on the degree of development of the disease. At the first stage, conservative treatment helps.

In mild cases, treatment is medicinal; in later stages, laser correction is used. And the last method is surgery.

Remember: severe eye disease is easier to prevent than to treat in its advanced form. Therefore, at the first alarming symptoms, immediately contact an ophthalmologist for professional help! From forty years of age and older, come for a preventive examination annually.

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Source: https://medic-help.ru/zabolevanija-glaz/kak-lecit-glaukomu-v-domasnih-usloviah/

Glaucoma

Glaucoma is a chronic eye pathology characterized by increased intraocular pressure, the development of optical neuropathy and visual impairment. Clinically, glaucoma is manifested by narrowing of visual fields, pain, pain and a feeling of heaviness in the eyes, blurred vision, deterioration of twilight vision, and in severe cases, blindness. Diagnosis of glaucoma includes perimetry, tonometry and tonography, gonioscopy, optical coherence tomography, laser retinotomography. Treatment of glaucoma requires the use of anti-glaucoma drops, the use of laser surgery methods (iridotomy (iridectomy) and trabeculoplasty) or anti-glaucomatous operations (trabeculectomy, sclerectomy, iridectomy, iridocycloretraction, etc.).

Glaucoma is one of the most dangerous eye diseases leading to vision loss. According to available data, glaucoma affects about 3% of the population, and 15% of blind people worldwide suffer from glaucoma as a cause of blindness.

People over 40 years of age are at risk for developing glaucoma, but in ophthalmology there are such forms of the disease as juvenile and congenital glaucoma. The incidence of the disease increases significantly with age: for example, congenital glaucoma is diagnosed in 1 in 10-20 thousand.

newborns; in the group of 40-45 year olds – in 0.1% of cases; in 50-60 year olds – in 1.5% of observations; after 75 years - in more than 3% of cases.

Glaucoma is understood as a chronic eye disease that occurs with periodic or constant increases in IOP (intraocular pressure), disorders of the outflow of intraocular fluid (intraocular fluid), trophic disorders in the retina and optic nerve, which is accompanied by the development of visual field defects and marginal excavation of the optic disc (optic disc). . The concept of “glaucoma” today combines about 60 different diseases that have the listed features.

Glaucoma

The study of the mechanisms of development of glaucoma allows us to talk about the multifactorial nature of the disease and the role of the threshold effect in its occurrence. That is, for glaucoma to occur, there must be a number of factors that together cause the disease.

The pathogenetic mechanism of glaucoma is associated with a 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 levels.

Normally, the aqueous humor produced by the ciliary body accumulates in the posterior chamber of the eye - a slit-like space located behind the iris. 85-95% of the eye fluid flows through the pupil into the anterior chamber of the eye - the space between the iris and cornea.

The outflow of intraocular fluid is ensured by a special drainage system of the eye, located in the corner of the anterior chamber and formed by the trabecula and Schlemm's canal (venous sinus of the sclera). Through these structures, the intraocular fluid flows into the scleral veins.

A small part of the aqueous humor (5-15%) flows out through the additional uveoscleral route, seeping through the ciliary body and sclera into the venous collectors of the choroid.

To maintain normal IOP (18-26 mm Hg), a balance is required between the outflow and inflow of aqueous humor.

In glaucoma, this balance is disturbed, as a result of which an excess amount of intraocular fluid accumulates in the eye cavity, which is accompanied by an increase in intraocular pressure above the tolerant level.

High IOP, in turn, leads to hypoxia and ischemia of eye tissue; compression, gradual degeneration and destruction of nerve fibers, disintegration of retinal ganglion cells and ultimately to the development of glaucomatous optic neuropathy and optic nerve atrophy.

The development of congenital glaucoma is usually associated with eye abnormalities in the fetus (dysgenesis of the anterior chamber angle), trauma, and eye tumors.

A predisposition to the development of acquired glaucoma exists in people with a family history of this disease, people suffering from atherosclerosis and diabetes mellitus, arterial hypertension, and cervical osteochondrosis.

Based on their origin, they distinguish between primary glaucoma, as an independent pathology of the anterior chamber of the eye, drainage system and optic disc, and secondary glaucoma, which is a complication of extra- and intraocular disorders.

In accordance with the mechanism underlying the increase in IOP, primary open-angle and closed-angle glaucoma are distinguished. In angle-closure glaucoma, there is an internal block in the drainage system of the eye; in the open-angle form, the angle of the anterior chamber is open, but the outflow of the intraocular fluid is impaired.

Depending on the level of IOP, glaucoma can occur in a normotensive variant (with tonometric pressure up to 25 mm Hg) or a hypertensive variant with a moderate increase in tonometric pressure (26-32 mm Hg) or high tonometric pressure (33 mm Hg). Art. and above).

Along the course, glaucoma can be stabilized (in the absence of negative dynamics within 6 months) and unstabilized (with a tendency to changes in the visual field and optic disc during repeated examinations).

According to the severity of the glaucomatous process, 4 stages are distinguished:

• I (initial stage of glaucoma) – paracentral scotomas are identified, there is an expansion of the optic disc, excavation of the optic disc does not reach its edge.
• II (stage of advanced glaucoma) – the field of view is changed in the parcentral region, narrowed in the infero- and/or superotemporal segment by 10° or more; excavation of the optic disc is of a marginal nature.
• III (stage of advanced glaucoma) – a concentric narrowing of the boundaries of the visual field is noted, the presence of a marginal subtotal excavation of the optic disc is detected.
• IV (terminal stage of glaucoma) – there is a complete loss of central vision or preservation of light perception. The optic disc condition is characterized by total excavation, destruction of the neuroretinal rim and shift of the vascular bundle.

Depending on the age of onset, glaucoma is divided into congenital (in children under 3 years of age), infantile (in children from 3 to 10 years of age), juvenile (in persons aged from 11 to 35 years of age) and glaucoma in adults (in persons over 35 years of age). Apart from congenital glaucoma, all other forms are acquired.

The clinical course of open-angle glaucoma is usually asymptomatic.

The narrowing of the visual field develops gradually, sometimes progressing over several years, so patients often accidentally discover that they can see in only one eye.

Sometimes there are complaints of blurred vision, the presence of rainbow circles before the eyes, headache and aching in the superciliary area, decreased vision in the dark. Open glaucoma usually affects both eyes.

During the angle-closure form of the disease, the phases of preglaucoma, acute attack of glaucoma and chronic glaucoma are distinguished.

An acute attack of angle-closure glaucoma is caused by complete closure of the angle of the anterior chamber of the eye. IOP can reach 80 mm. rt. Art. and higher.

An attack can be provoked by nervous tension, overwork, drug-induced dilation of the pupil, prolonged exposure to darkness, or prolonged work with the head bowed.

During an attack of glaucoma, there is a sharp pain in the eye, a sudden drop in vision down to light perception, eye hyperemia, dimming of the cornea, dilation of the pupil, which acquires a greenish tint.

That is why the typical symptom of the disease got its name: “glaucoma” is translated from Greek as “green water”. An attack of glaucoma can occur with nausea and vomiting, dizziness, pain in the heart, under the shoulder blade, and in the abdomen. The eye becomes stony to the touch.

An acute attack of angle-closure glaucoma is an emergency and requires an immediate, within the next few hours, reduction of IOP by medication or surgery. Otherwise, the patient may face complete irreversible loss of vision.

Over time, glaucoma takes a chronic course and is characterized by a progressive increase in IOP, recurrent subacute attacks, and increasing blockade of the anterior chamber angle. The outcome of chronic glaucoma is glaucomatous atrophy of the optic nerve and loss of visual function.

Early detection of glaucoma has important prognostic significance, determining the effectiveness of treatment and the state of visual function. The leading role in the diagnosis of glaucoma is played by the determination of IOP, a detailed study of the fundus and optic disc, examination of the visual field, and examination of the angle of the anterior chamber of the eye.

An integral part of the examination for glaucoma is perimetry - determining the boundaries of the visual field using various techniques - isopperimetry, campimetry, computer perimetry, etc. Perimetry allows us to identify even initial changes in the visual fields that are not noticed by the patient himself.

Using gonioscopy for glaucoma, the ophthalmologist has the opportunity to assess the structure of the angle of the anterior chamber of the eye and the condition of the trabecula through which the outflow of the intraocular fluid occurs. An ultrasound of the eye helps to obtain informative data.

The condition of the optic disc is the most important criterion for assessing the stage of glaucoma. Therefore, the complex of ophthalmological examination includes ophthalmoscopy - a procedure for examining the fundus of the eye. Glaucoma is characterized by deepening and widening of the vascular funnel (excavation) of the optic disc. In the stage of advanced glaucoma, marginal excavation and discoloration of the optic nerve head are noted.

A more accurate qualitative and quantitative analysis of structural changes in the optic disc and retina is carried out using laser scanning ophthalmoscopy, laser polarimetry, optical coherence tomography or Heidelberg laser retinotomography.

There are three main approaches to the treatment of glaucoma: conservative (medication), surgical and laser. The choice of treatment tactics is determined by the type of glaucoma.

The goals of drug treatment of glaucoma are to reduce IOP, improve blood supply to the intraocular part of the optic nerve, and normalize metabolism in the tissues of the eye.

Antiglaucoma drops according to their action are divided into three large groups:

1. Drugs that improve the outflow of intraocular fluid: miotics (pilocarpine, carbachol); sympathomimetics (dipivefrine); prostaglandins F2 alpha – latanoprost, travoprost).
2. Agents that inhibit the production of intraocular fluid: selective and non-selective ß-blockers (betaxolol, betaxolol, timolol, etc.); a- and beta-blockers (proxodolol).
3. Combination drugs.

When an acute attack of angle-closure glaucoma develops, an immediate reduction in IOP is required. Relief of an acute attack of glaucoma begins with the instillation of a miotic - 1% pilocarpine solution according to the scheme and timolol solution, the prescription of diuretics (diacarb, furosemide).

Simultaneously with drug therapy, distracting measures are carried out - cupping, mustard plasters, leeches on the temporal region (hirudotherapy), hot foot baths.

To remove the developed block and restore the outflow of the intraocular fluid, it is necessary to perform laser iridectomy (iridotomy) or basal iridectomy surgically.

The methods of laser surgery for glaucoma are quite numerous. They differ in the type of laser used (argon, neodymium, diode, etc.)

), method of influence (coagulation, destruction), object of influence (iris, trabecula), indications for implementation, etc.

In laser surgery for glaucoma, laser iridotomy and iridectomy, laser iridoplasty, laser trabeculoplasty, and laser goniopuncture are widely used. For severe degrees of glaucoma, laser cyclocoagulation can be performed.

Antiglaucomatous operations have not lost their relevance in ophthalmology. Among fistulizing (penetrating) operations for glaucoma, the most common are trabeculectomy and trabeculotomy.

In order to reduce the production of intraocular fluid in glaucoma, cyclocryocoagulation is performed.

It is necessary to understand that it is impossible to completely cure glaucoma, but this disease can be kept under control. At an early stage of the disease, when irreversible changes have not yet occurred, satisfactory functional results in the treatment of glaucoma can be achieved. Uncontrolled glaucoma leads to irreversible vision loss.

Prevention of glaucoma consists of regular examinations by an ophthalmologist of persons at risk - with a burdened somatic and ophthalmological background, heredity, and over 40 years of age. Patients suffering from glaucoma should be registered with an ophthalmologist, regularly visit a specialist every 2-3 months, and receive recommended treatment for life.

Source: https://www.KrasotaiMedicina.ru/diseases/ophthalmology/glaucoma

Glaucoma

Glaucoma is a progressive disease that leads to irreversible blindness.

Due to increased intraocular pressure in glaucoma, retinal cells are destroyed, the optic nerve atrophies, and visual signals stop entering the brain.

A person begins to see worse, peripheral vision is impaired, as a result of which the visibility area is limited.

Mentions of glaucoma (translated from Greek this word means “green color of the sea”) are found in the works of Hippocrates dating back to 400 BC. However, modern ideas about glaucoma began to take shape only in the middle of the 9th century.

Currently, glaucoma is understood as a fairly large group of diseases, often of different origins and with different courses. There is still no consensus on what causes the development of these ailments, but in the absence of treatment, their outcome is the same - optic nerve atrophy and blindness.

Glaucoma

Normal vision

“Risk groups” for glaucoma include:

• people over 60-70 years of age who do not even have eye complaints;
• people over 40 years of age who:
  • intraocular pressure is in the upper limit of normal;
  • the difference between the intraocular pressure of the right and left eyes is more than 5 mmHg. Art.;
  • the difference between intraocular pressure measured in the morning and evening is more than 5 mmHg. Art.;
• people with a high degree of myopia after 40-50 years, with a high degree of farsightedness (especially women after 50 years);
• people with increased intraocular pressure, regardless of age;
• people with low (relative to age norm) blood pressure;
• people with diabetes, endocrine, nervous and cardiovascular diseases;
• people who have suffered eye injuries, inflammatory diseases (uveitis, iridocyclitis, etc.) of the eyes, eye surgery;
• relatives (including distant ones) of patients with glaucoma with similar structural features of the eye;
• people undergoing a long course of treatment with hormonal drugs.

Glaucoma can occur at any age, but the disease most often develops in older people.

• Age groups
• Newborns
• 40-50 years
• 60-75 years

1. Disease frequency
2. There is 1 case of glaucoma in approximately 10,000 newborns.
3. Experts diagnose primary glaucoma in approximately 0.1% of the population.
4. In this age group, glaucoma occurs in approximately 1.5-2% of cases.

According to the World Health Organization, glaucoma is a major disease that, if not treated promptly, irreversibly causes blindness. More than 5 million people have lost their sight due to glaucoma, accounting for 13.5% of all blind people in the world.

Causes of glaucoma development

In a healthy eye, a certain pressure is constantly maintained (18-22 mm Hg) due to the balance of fluid inflow and outflow. With glaucoma, this circulation is disrupted, fluid accumulates, and intraocular pressure begins to rise.

The optic nerve and other structures of the eye experience increased stress, and the blood supply to the eye is disrupted. As a result, the optic nerve atrophies and visual signals stop reaching the brain.

A person begins to see worse, peripheral vision is impaired, as a result of which the area of ​​​​visibility is limited - and eventually blindness may occur.

Glaucoma is an irreversible disease. Therefore, it is very important to start treatment on time.

The main symptoms of glaucoma are:

• pain, pain, feeling of heaviness in the eyes, narrowing of the field of vision;
• blurred vision, the appearance of a “mesh” before the eyes;
• when looking at a bright light, for example, a lamp, “rainbow circles” appear before the eyes;
• deterioration of vision in the evening and at night;
• feeling of eye moistening;
• minor pain around the eyes;
• redness of the eyes.

Forms of glaucoma

• Open angle glaucoma
• Angle-closure glaucoma

The open-angle form is diagnosed in more than 90% of cases of glaucoma.

In open-angle glaucoma, access to the natural drainage system is open, but its functions are impaired. The result is a gradual increase in intraocular pressure. As a rule, open-angle glaucoma is characterized by an asymptomatic, almost imperceptible course of the disease.

Since the field of vision narrows gradually (the process can continue for several years), a person sometimes accidentally discovers that he can see in only one eye.

In some cases, one can identify complaints about the periodic appearance of rainbow circles when looking at a light source, “fogging,” and asthenopic complaints associated with weakened accommodation.

In angle-closure glaucoma, intraocular fluid accumulates due to the fact that there is no access to the natural drainage system of the eye - the iris blocks the angle of the anterior chamber. As a result, the pressure increases, and this can lead to an acute attack of glaucoma, which is accompanied by:

• sharp pain in the eye and the corresponding half of the head;
• obvious visual disturbances (blurred vision or its sharp decrease up to complete blindness);
• redness of the eye (dilation of the vessels of the anterior segment of the eyeball), corneal edema, decreased depth of the anterior chamber, dilation of the pupil and lack of its reaction to light;
• the appearance of halos around light sources.

Ophthalmologists draw attention to the fact that as a result of an acute attack of glaucoma, sudden loss of vision is possible.

Diagnosis of glaucoma

To detect the onset of the disease, simply measuring intraocular pressure is not enough. It is necessary to examine the fundus and optic nerve head in detail, as well as examine the visual fields, that is, conduct a thorough diagnostic examination.

In Excimer ophthalmology clinics, examinations are performed using a whole range of modern computerized equipment and include:

• study of the visual field (using a computer perimeter);
• measurement of refraction (the ability of the optical system of the eye to refract light rays);
• measurement of intraocular pressure;
• ultrasound examinations;
• determining the depth of the anterior chamber of the eye and the thickness of the lens (since high pressure is often caused by displacement or enlargement of the lens);
• Using gonioscopy, the structure of the anterior chamber angle, through which fluid outflows from the eye, is assessed.

Also, during the diagnosis, an examination is necessarily carried out on a computer perimeter and on a fundus analyzer - a unique device available in the equipment of a few Russian clinics. This makes it possible to identify the initial manifestations of glaucoma that occur before changes in the visual field, and to stop the onset of the pathological process in time.

How to deal with glaucoma?

Remember, without timely detection of the disease and timely treatment, vision is irretrievably lost! The Excimer Clinic offers its patients the most advanced and reliable methods for diagnosing and treating glaucoma. Don’t delay treatment, don’t risk the health of your eyes!

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• È
• How can glaucoma be cured?

Depending on the form, stage, and concomitant diseases, Excimer clinics will select an individual treatment program for you. Medications are mainly aimed at reducing intraocular pressure. But it is important to remember that drops do not restore the fluid balance in the eye, but only artificially maintain it. Moreover, it is necessary to periodically adjust the dose of the drug itself.

As for surgical treatment, the operation of non-penetrating deep sclerectomy (NGSE) allows you to restore the natural balance of fluid in the eye in open-angle forms of glaucoma.

For closed-angle forms, both traditional operations and the method of removing the transparent lens with implantation of an intraocular lens are used (if the size of the lens does not correspond to the size of the eye).

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2. È
3. What medications help against glaucoma?

After the age of 40 (when glaucoma usually occurs), people often have more than one disease. This means that when selecting a drug, you need to take into account all the features and compatibility with other medications.

Many antiglaucomatous drugs have a number of side effects. For example, such drugs are contraindicated for people with vascular diseases, bronchial asthma and a number of other diseases. Therefore, only a specialist can prescribe them.

Don't self-medicate!

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• What are the limitations for glaucoma?

Patients with glaucoma are not recommended: heavy physical activity in an inclined position, heavy lifting, prolonged exposure to the sun, visiting baths, saunas.

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Source: https://excimerclinic.ru/glaucoma/

Why does eye glaucoma occur: causes and development of the disease

Glaucoma is a common disease. In 2010, about 45 million people were identified with open-angle glaucoma. The disease is dangerous due to the lack of effective prevention measures.

What is glaucoma?

Glaucoma is an eye disease that leads to a permanent decrease in vision up to complete blindness. Glaucoma ranks first in the structure of disability for eye diseases. Occurs more often in adults.

Caused by various reasons. Regardless of the etiology, it includes the same pathogenetic stages of development:

• increased pressure inside the chambers of the eye;
• damage to the optic nerve;
• the occurrence of visual impairment.

Why does it happen?

Anterior to the lens lies the anterior chamber of the eye. Behind is the rear camera. Inside the posterior chamber are the ligaments of Zinn, which connect the lens and the ciliary muscle (regulates the curvature of the lens). The processes of the ciliary muscle produce a special liquid - aqueous humor.

This fluid enters first into the posterior chamber of the eye, then through the lens into the anterior chamber. Having delivered nutrients, the fluid flows into the corners of the eye, which are covered by the pectineal ligament. Thus, a balance is maintained between the secretion and outflow of intraocular fluid.

The occurrence of glaucoma is due to a shift in balance.

Excess fluid puts pressure on the vitreous body. It compresses the retina. The retinal cells that are responsible for image formation die. First, cells along the periphery are damaged. Vision disappears at the edges. If left untreated, the optic nerve dies. The person completely loses his vision.

How it manifests itself

There are symptoms that help to suspect glaucoma in the initial stages. Patient complaints may vary depending on the cause of the disease.

1. Early stage: Deterioration of vision in the periphery. Often patients do not notice changes. Sometimes they complain of rainbow circles and dark spots. Over time, the field of vision narrows;
2. Late stage: Complete loss of vision due to irreversible damage to the optic nerve. A small area of ​​vision is sometimes retained in the temple area.

Forms of the disease

Depending on the cause of glaucoma, various forms of the disease are distinguished. There are several classifications.

Classification by development mechanisms:

1. Open-angle form of glaucoma. The corner of the eye is open. However, the spaces between the fibers of the pectineal ligament, which covers the canthus, are reduced. Aqueous humor does not penetrate the ligaments and is retained in the chambers of the eye. Occurs in 9 out of 10 cases of glaucoma.
2. Primary open angle. Associated with direct pathology of the trabeculae of the pectineal ligament. There are various reasons for the development of this form of the disease. The main one is age-related changes after 35 years. Characterized by an asymptomatic course. The anatomical features of the eye structure increase the likelihood of developing the disease.
3. Exfoliative open angle. The reasons for its appearance are disturbances in biochemical processes in the connective tissue of the body. The by-product in the form of layers (exfoliant) settles on the pectineal ligament and prevents the outflow of fluid. Occurs in adults.
4. Pigmented open-angle. The pigment exfoliated from the iris clogs the trabeculae of the ligament. Aqueous humor does not drain from the eye. It occurs at a young age, unlike other forms of open-angle glaucoma.
5. Angle-closure form of glaucoma. It occurs in the form of attacks, which are provoked by drops that dilate the pupil and insufficient lighting. The reasons are dilation of the pupil, which causes thickening of the root of the iris. The corner of the eye closes. The block prevents the outflow of fluid. More often develops in the presence of farsightedness. A large lens and a narrow angle of the eye from birth is what causes angle-closure glaucoma.

Classification by reason of occurrence:

1. Primary. An independent pathology that is not associated with damage to other body systems;
2. Secondary. Develops secondary to other diseases and medications.

Classification by age of onset:

1. Congenital primary. Occurs in children under 2 years of age without provoking causes. Occurs less frequently than in adults. Caused by a violation of the development of the anterior chamber angle. You can suspect it by photophobia and constant lacrimation. During examination, the ophthalmologist reveals an enlarged eyeball.
2. Infantile primary. Develops in children from 3 to 11 years old. The pathogenesis is the same as that of congenital glaucoma.
3. Juvenile primary. From 12 to 36 years. The same development mechanism.
4. Glaucoma in adults. The most common form.

Causes

Why does eye glaucoma occur? Often the disease is caused by a group of factors. The main thing that causes the disease is intraocular hypertension syndrome.

Genetic reasons:

1. If glaucoma is detected in close relatives, then the likelihood of developing the disease increases 2–4 times. Specific genes responsible for the occurrence of glaucoma have been identified;
2. The anatomical features of the eye (small vitreous body, large lens, narrow angle of the anterior chamber of the eye) prevent proper outflow of fluid.

Anomalies of eye development:

• underdeveloped trabeculae of the pectineal ligament (the ligament that covers the corner of the eye);
• underdeveloped ciliary muscle (as a result, the tone of the pectineal ligament decreases);
• a congenital block of fluid outflow due to the close proximity of the iris and cornea, which leads to the development of glaucoma.

Age-related changes in the eye:

• in adults, due to the occurrence of degenerative changes, the capacity of the pectineal ligament decreases;

Metabolic disorders:

• pseudoexfoliation syndrome (an exfoliant substance is deposited in the trabecular system);
• pigment syndrome (desquamated iris pigment clogs the corner of the eye).

Factors causing narrowing of the iridocorneal angle:

• farsightedness (focusing the eye on distant objects leads to the expansion of the lens, which closes the entrance to the angle between the cornea and the iris);
• the use of drops that dilate the pupil (a fold forms at the base of the iris, preventing the outflow of aqueous humor).

Extraocular causes:

• diabetes mellitus, which leads to retinopathy;
• taking steroid drugs.

Basic treatment methods

Optic nerve dystrophy is an irreversible process. However, it is possible to prevent its damage and slow down the development of the disease. The main goal is to reduce intraocular pressure. Eye drops are used for this.

To treat congenital forms, surgical treatment methods are used (introduction of a microcatheter, removal of part of the trabecular meshwork, laser plastic surgery of the trabecular meshwork, laser opening of Schlemm's canal through which fluid flows).

Surgery does not guarantee a complete cure for the disease. Often it causes only temporary improvement. The specific surgical method is selected depending on the causes of fluid outflow disturbance.

Anastasia Mikhailovna, specialist for the website glazalik.ru
Share your experience and opinion in x.

Source: https://GlazaLik.ru/bolezni-glaz/glaukoma/prichiny/

What is glaucoma, its causes and consequences, symptoms and treatment in adults, occurrence and development, prevention

There are eye diseases that develop unnoticed but can lead to blindness. One of these pathologies is glaucoma. This chronic eye disease develops against the background of increased intraocular pressure. If the pressure inside the eye is constantly high, the optic nerve dies, and this, in turn, leads to complete loss of vision.

Glaucoma is a common disease. According to statistics, 14-15% of all blind people on the globe have lost their sight precisely for this reason. Is it possible to stop the development of glaucoma and preserve vision?

Definition of disease

Glaucoma is an eye disease that develops almost asymptomatically. As a result, the optic nerve and retina of the eye are damaged. Glaucoma is associated with increased intraocular pressure; Without timely detection and treatment, the disease leads to blindness.

Damage to the optic nerve due to glaucoma is irreversible and leads to complete loss of vision, so it is important to identify and treat this disease in a timely manner.

Development mechanism

A special liquid is constantly formed in our eyes - aqueous humor, which is concentrated in the anterior (between the cornea and iris) and posterior (between the iris and lens) chambers of the eye.

In the corner of the anterior chamber there is a complex drainage system through which aqueous humor enters the bloodstream. The balance between the formation and outflow of aqueous humor determines the intraocular pressure that the contents of the eyeball exert on its walls.

For most healthy people it ranges from 16 to 22 mmHg.

With glaucoma, circulation in the affected eye is disrupted: fluid accumulates and intraocular pressure increases. As a result, the eyeball begins to put pressure on the optic nerve, causing its destruction.

If the optic nerve dies, complete blindness occurs; these changes are irreversible.

With glaucoma, there is also a sudden loss of vision as a result of an acute attack.

Forms

There are 2 main forms of glaucoma:

1. Open angle;
2. Closed angle.

In the second form, fluid accumulates inside the eye due to the fact that the iris blocks the angle of the anterior chamber of the eye and blocks access to the natural drainage system of the eye. With an open-angle form, access is open, but the functions of the drainage system itself are impaired.

There is also a mixed form of glaucoma.

Causes

Intraocular pressure increases in cases where the removal of intraocular fluid is impaired. There are 3 main types of glaucoma: primary, congenital and secondary. Primary glaucoma is the most common. Appears without obvious reasons in people over 40 years of age.

Congenital glaucoma is caused by abnormalities in the embryonic development of the eye: dysgenesis of the anterior chamber angle, as well as a consequence of other eye diseases (tumors, inflammation, trauma) suffered by the mother before or during childbirth.

Secondary glaucoma is a consequence of a previous eye disease. Its reasons may be:

• Inflammatory eye diseases: keratitis, uveitis, scleritis;
• Lens shift;
• Cataract;
• Dystrophic eye diseases;
• Contusions, burns, eye injuries;
• Eye surgeries;
• Tumor of the eye.

A local factor influencing the development of glaucoma is myopia. Common factors include:

• Age (from 60 years);
• Heredity;
• Diabetes;
• Hypotension;
• Diseases of the thyroid gland, nervous system, etc.

Symptoms

Manifestations in which you should seek help from an ophthalmologist:

Symptoms indicating an attack of acute glaucoma:

• Severe, bursting pain in the eye;
• Pain around the eye;
• Nausea, vomiting;
• Heartache;
• Swelling of the eye media;
• Increased blood pressure.

These symptoms indicate a dangerous condition that requires emergency care and surgical treatment.

Possible complications

A complication of glaucoma is complete loss of vision and painful glaucoma, which can lead to removal of the eye.

If treatment is started on time, the symptoms of glaucoma remain at the stage at which the disease was detected. It is likely that with continued therapy the symptoms will not progress.

Treatment

There are 3 main methods of treating glaucoma:

1. Medication (conservative);
2. Laser;
3. Surgical.

The choice of treatment tactics for a patient depends on the type and form of glaucoma.

By medication

Currently, conservative treatment of glaucoma is carried out in 3 main areas:

1. Therapy aimed at reducing intraocular pressure (ophthalmic hypotensive therapy);
2. Treatment to improve blood supply to the inner membranes of the eye and the intraocular part of the optic nerve;
3. Therapy aimed at normalizing metabolism in the tissues of the eye in order to influence the degenerative processes characteristic of glaucoma.

The key point in the treatment of glaucoma is to normalize the level of intraocular pressure (IOP). Other types of therapy aimed at improving blood circulation and influencing metabolic processes in the eye are only auxiliary.

Medicines used in the treatment of glaucoma are divided into 2 large groups:

The first group includes:

• Miotics (Pilocarpine, Carbachol);
• Sympathomimetics (Epinephrine, Dipivefrin, Oftan-dipivefrin);
• Prostaglandins F2 alpha (Patanoprost, Travoprost).

Agents that inhibit the production of intraocular fluid:

• Selective sympathomimetics (Clonidine, Clonidine);
• Beta-blockers (Timolol, Timohexal, Arutimol, Kusimolol, Niolol, Betaxolol);
• Carbonic anhydrase inhibitors (Dorzolamide, Brinzolamide);
• Combined drugs (Proxofelin, Fotil, Normoglaucon, Kosopt).

Laser treatment

Laser surgery is aimed at eliminating intraocular blocks that occur in the outflow of intraocular fluid in the eye.

The action of lasers is based on the use of one of two techniques:

1. Coagulator lasers: application of a local burn to the trabecular area, followed by atrophy and scarring of its tissue.
2. Destructor lasers: creating a micro-explosion, which is accompanied by tissue rupture and a shock wave.

Many types of antiglaucoma laser operations have been proposed, but the most widespread are:

• Laser iridotomy (iridectomy);
• Laser trabeculoplasty.

Advantages of laser surgery:

• Restoring the outflow of intraocular fluid through natural pathways;
• Application of local anesthetic;
• Carrying out surgery on an outpatient basis;
• Minimum rehabilitation period;
• No complications;
• Low cost.

Minuses:

• Limited effect of the operation;
• The occurrence of a reactive syndrome: an increase in IOP in the first hours after laser intervention and the development of an inflammatory process in the future;
• The likelihood of damage to the cells of the posterior epithelium of the cornea and the lens capsule and iris vessels;
• Formation of adhesions in the affected area.

Surgical intervention

Currently, the question of indications for surgical treatment of glaucoma remains open.

Most ophthalmologists consider the main indications for surgical treatment of glaucoma to be:

• Persistent and severe increase in intraocular pressure, despite the use of topical medications;
• Progressive deterioration of the visual field;
• Negative dynamics of clinical data, i.e. unstabilized nature of the glaucomatous process.

The main objectives of antiglaucoma operations:

• Reduction and normalization of IOP;
• Creating conditions for microcirculation in the optic nerve;
• Removing the phenomena and consequences of hypoxia;
• Improvement in nerve nutrition and tissue metabolism.

Types of glaucoma operations:

• Penetrating surgeries, such as trabeculectomy;
• Non-penetrating operations, among which the most popular is sclerectomy;
• Operations that normalize the circulation of aqueous humor in the intraocular globe (iridectomy, iridocycloretraction);
• Operations aimed at reducing the production of aqueous humor (cyclocryocoagulation and laser cyclocoagulation).

Patients with glaucoma should not:

• Drink alcohol, strong coffee and tea;
• Smoking;
• Work in hazardous industries, for example, in the production of kvass and other fermentation products;
• Stay in a position with your torso and head tilted for a long time:

You should avoid staying in a dark room for a long time: sudden changes in lighting are harmful to the eyes. You can watch TV and read only in a lighted room. You should avoid going to the cinema.

Prevention

After 40 years, every person should be examined by an ophthalmologist at least 1-2 times a year. This is especially important for people with myopia, farsightedness, heredity of glaucoma and those who have undergone eye surgery.

Things to remember:

• Environmental pollution, constant work at the computer and eating in a hurry lead to a sharp decrease in vision already at a young age.
• Long-term work at the computer, when a person forgets to blink his eyes, provokes dry eye syndrome and various chronic diseases - conjunctivitis, blepharitis. Active computer users should take breaks of 10-15 minutes every hour and a half of work, performing special gymnastics for the eyes, and use special moisturizing drops.
• You can watch TV continuously for no longer than 1 – 1.5 hours at a distance of 3 or more meters from the screen.
• Reading is safer for your eyesight than working at a computer or watching TV: your eyes move all the time, which means they become moisturized.
• Children under 18 years of age can improve their vision with the help of special exercises, drops and simulator glasses.
• It is recommended to eat foods rich in vitamin A: carrots, tomatoes, persimmons and other orange fruits. Nutrients are better absorbed with butter or sour cream. A good friend for the eyes is blueberries. During the season, you should eat at least 1 glass of berries a day; the rest of the time you can take blueberry preparations.
• To preserve your vision naturally, you need to play tennis, swim and spend more time outdoors.

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conclusions

Early diagnosis of glaucoma is the best way to avoid blindness. The asymptomatic nature of this disease makes it insidious. This means that the main preventative measure is regular examinations by an ophthalmologist. Patient adherence to serious and timely treatment is one of the main factors for success in the fight against glaucoma.

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Source: https://EyesDocs.ru/zabolevaniya/glaukoma/metody-lecheniya-i-mery-profilaktiki.html