Glaucoma

General description of the disease

It is a chronic eye disease that can develop at any age, but it is especially common among the elderly. Congenital glaucoma occurs in 1 out of 20 thousand newborns, by the age of 45, the incidence of glaucoma is approximately 0,1%, among 50-60-year-old people this figure reaches 1,5%, and in the age group 70+ more than 3%.

Unfortunately, glaucoma is incurable, its severe forms lead to irreversible blindness, which gives the disease a social character.

Types of glaucoma

Glaucoma is classified by age:

• congenital glaucoma newborns suffer. As a rule, the disease is subject to early diagnosis, immediately after birth it is detected in 60% of patients. Congenital glaucoma can manifest itself in the first months of infancy, and in rare cases much later, after several years;
• juvenile glaucoma diagnosed in children who have reached 3 years of age and up to 35 years;
• primary glaucoma in adults most common. It is associated with age-related changes in the organs of vision. Its forms are subject to medical classification, on which the treatment regimen depends. Primary glaucoma can manifest itself in open-angle, closed-angle, mixed forms and glaucoma, in which intraocular pressure remains within normal limits;
• secondary glaucoma in adults develops as a consequence of the transferred ophthalmic diseases.

Causes of glaucoma

The causes of congenital glaucoma can be a variety of factors, such as genetic predisposition, as well as embryonic and birth trauma. If the mother has suffered infections such as mumps, syphilis, rubella, polio during pregnancy, then this can provoke glaucoma in the fetus. Excessive alcohol consumption, poisoning, vitamin deficiency, radiation exposure, and fetal abdominal trauma can also be risk factors.

In adults, the main reason for the development of glaucoma is increased eye pressure, which leads to a violation of the blood supply to the eyes and deformation of the optic nerve. In addition, the disease provokes high blood pressure, diabetes mellitus, osteochondrosis of the cervical spine, diseases of the immune system, severe myopia and a hereditary factor.^[3].

The tendency to a closed-angle form is more often manifested in the fair sex. In this case, the anatomical features of the organs of vision are of particular importance: the small size of the eye and the large lens.

Secondary glaucoma can be provoked by long-term use of hormonal drugs, indicated for bronchial asthma and autoimmune diseases.

Risk factors for developing glaucoma

Most often, glaucoma is diagnosed in the presence of the following adverse factors:

1. old age (after 70);
2. farsightedness;
3. periodically rising IOP;
4. low blood pressure;
5. diabetes;
6. dysfunction of the hormonal and nervous systems;
7. diseases of the cardiovascular system;
8. eye damage;
9. surgery and past inflammatory processes;
10. the presence of glaucoma in relatives;
11. long-term use of hormonal drugs.

According to the WHO, glaucoma is the leading pathology of the visual apparatus, leading to loss of visual function. More than 14% of the world’s blind people have lost their sight due to glaucoma.

Glaucoma symptoms

Very often, the course of the disease is asymptomatic and does not cause any discomfort as long as the visual acuity does not significantly deteriorate. As a rule, the patient consults an ophthalmologist at a late stage in the development of the disease. The insidiousness of the disease lies in the fact that in the early stages, pain and symptoms are almost completely absent.

Elderly people should regularly visit an ophthalmologist and measure intraocular pressure, which is the leading symptom of glaucoma. It is impossible to independently detect changes in intraocular pressure, since the increase occurs gradually and the brain adapts to the changes. Only a small group of people have such manifestations as pain in the area of ​​the eyebrows and forehead, deterioration in sharpness of vision, complaints about the appearance of colored circles when looking at light sources.

Another important symptom is a narrowing of the field of vision, which begins from the nasal zone, as well as a violation of the quick adaptation of the eye to a change in lighting. A drop in visual acuity indicates irreversible changes in the morphological structure of the optic nerve, which cannot be restored and treated.

The closed-angle form is quite rare, but it is distinguished by pronounced symptoms: severe eye and headaches, redness of the eye.

Clinical signs of glaucoma

The lesion of the visual organ may be manifested by one or more symptoms. It is important to contact an ophthalmologist in time for examination and comprehensive diagnostics.

Signs of glaucoma:

1. recurrent feeling of pain, soreness and heaviness in the area of ​​the affected eye;
2. decrease in the field of view;
3. fog before the eyes;
4. colored spots and circles when looking at a source of bright light;
5. decreased vision at dusk (in the evening and at night);
6. eye moisture;
7. occasional mild soreness;
8. hyperemia of the eyeball.

Complications of glaucoma

Untimely treatment and diagnosis of glaucoma can provoke acute attacks of the disease, which are fraught with severe visual impairment up to complete blindness. Practical research shows that glaucoma treatment can only stop and slow down the decline in vision, but cannot restore it.

Prevention of glaucoma

1. 1 regular medical examinations with a therapist and endocrinologist for the timely detection and prevention of diseases that can provoke the development of glaucoma (hypertension, hypotension, diabetes mellitus, dysfunction of the thyroid gland);
2. 2 systematic visit to the ophthalmologist with the obligatory measurement of intraocular pressure;
3. 3 timely treatment of ophthalmic diseases to prevent the development of secondary glaucoma;
4. 4 expectant mothers should be especially careful to prevent the risk of developing glaucoma in newborns;
5. 5 do not neglect self-examination. Self-control is carried out quite simply: shut your eyes one by one and compare the sharpness and quality of the picture;
6. 6 make it a rule to regularly do morning exercises with mandatory exercises for the cervical spine. Moderate physical activity stimulates blood supply to the organs of vision;
7. 7 do not lift heavy objects in order not to provoke an increase in IOP;
8. 8 a properly composed diet.

Diagnostic methods

For early detection of pathological processes, IOP is measured, with the help of special devices the fundus and the optic nerve head are examined, the visual field is examined to identify defects in central and peripheral vision.

For the diagnosis of glaucoma, a comprehensive examination is prescribed, including refractometry, automated perimetry, tonometry, ultrasound, assessment of the depth of the anterior chamber, determination of the thickness and diameter of the lens, gonioscopy (study of the angle between the cornea and the iris), determination of the thickness of the cornea.

Glaucoma treatment in mainstream medicine

Unfortunately, it is not yet possible to achieve a complete cure for glaucoma, but it must be controlled and treated. Having determined the type and stage of glaucoma, the ophthalmologist will prescribe the optimal treatment method, which can be conservative, surgical or laser. Each of these types of treatment is aimed at normalizing the indicators of intraocular pressure.

The drug tactics of treatment involves the use of special antiglaucoma drops, which not only reduce the level of IOP, but also improve the blood supply to the inner membranes of the organs of vision. Only an ophthalmologist can choose and cancel drops, as well as prescribe an instillation regime; self-medication for glaucoma can cause irreversible damage to the eyes. In this case, the patient should take into account that antiglaucomatous drugs can act differently on IOP:

1. 1 intraocular pressure decreases immediately after instillation of drops;
2. 2 IOP decreases slightly, but under the condition of regular instillation of the drug, its effect increases over time;
3. 3 drops can cause the opposite effect and increase the level of IOP;
4. 4 the patient’s resistance to antiglaucoma drops is possible, in this case the drug does not affect the IOP parameters.

If conservative treatment has not yielded results, then the ophthalmologist recommends surgery.

Laser surgery for the treatment of glaucoma began to be practiced back in the 70s of the last century. With the help of laser radiation, intraocular blocks are removed, which interfere with the outflow of intraocular fluid. There are advantages and disadvantages to laser surgery.

The advantages of laser surgery:

• relatively low cost of the operation;
• short rehabilitation period;
• no need for general anesthesia, local anesthesia is sufficient;
• surgical intervention with a laser can be performed on an outpatient basis;
• there are no complications typical for traditional glaucoma surgery.

Disadvantages of laser surgery:

• the risk of damage to the lens capsule;
• the possibility of damage to the vessels of the iris;
• in the first few hours after the operation, an increase in IOP is possible.

Glaucoma surgery has a history of over 150 years. Every year the existing ones are improved, new methods of antiglaucomatous operations are developed and introduced. The ophthalmologist accepts the question of the surgical treatment of glaucoma (iridectomy), taking into account the general condition of the patient, IOP parameters and the dynamics of clinical data.

The task of iridectomy is to normalize the IOP level, improve nutrition and tissue metabolism in the optic nerve. As a result of surgical operations, the pressure in the eye chambers is equalized by eliminating the pupillary block.

Attention!

The administration is not responsible for any attempt to use the information provided, and does not guarantee that it will not harm you personally. The materials cannot be used to prescribe treatment and make a diagnosis. Always consult your specialist doctor!