Glaucoma in adults
Glaucoma in modern medicine is given much attention. And not in vain – if you do not prevent this disease in time, you can be left without sight. About the causes of the disease, treatment, prevention – in the material of the KP

What is glaucoma

Glaucoma is a severe eye disease that leads to blindness. In a healthy eye, a certain pressure is maintained (18-22 mm Hg) due to the balance of fluid inflow and outflow. In glaucoma, this circulation is disrupted, fluid builds up, and intraocular pressure begins to rise.

The optic nerve and other structures of the eye experience an increased load, the blood supply to the eye is disturbed. As a result, the optic nerve atrophies, and visual signals cease to flow to the brain. A person begins to see worse, peripheral vision is impaired, as a result of which the visibility zone is limited – as a result, blindness may occur.

Usually glaucoma occurs in people over 40 years old, however, as ophthalmologists note, the disease is getting younger every year. Early diagnosis of glaucoma is often very difficult, since in the early stages the disease does not cause concern in patients.

What you need to know about glaucoma

Risk groupspeople over 70, those whose relatives suffered from glaucoma, who have diabetes mellitus, heart and vascular diseases
Signs of glaucomapain, pain, heaviness in the eye, fog before the eyes, narrowing of the field of vision, colored spots when looking at the light
Formsopen-angle (90%), closed-angle
Treatmentmedicines, surgery, laser therapy

Causes of glaucoma in adults

– Most often, glaucoma is accompanied by an increase in intraocular pressure, but this is already a mechanism for the implementation of the disease. As such, the cause of glaucoma is a hereditary predisposition, and there are also risk factors that increase the risk of developing it. These include myopia, hypotension, says Natalya Voroshilova, Candidate of Medical Sciences, ophthalmologist.

  • genetic predisposition – the disease is inherited;
  • anomalies of intrauterine development – in this case, glaucoma will be congenital;
  • myopia;
  • farsightedness;
  • long-term use of steroid drugs;
  • inflammation in the eye (uveitis, keratitis, scleritis);
  • injuries – various injuries (burns, wounds, concussions);
  • diabetes.

Signs of glaucoma in adults

– Glaucoma is classified as an insidious disease precisely because it can occur for a long time without any signs. Some people encounter “rainbow circles” in the morning, but they are not observed in everyone and are associated with the fact that it is in the morning hours that an increase in eye pressure is more often observed. This is accompanied by a change in the refractive properties of the cornea, and such optical effects occur, says the doctor.

The reasons also include:

  • pain, pain, feeling of heaviness in the eyes, narrowing of the field of vision;
  • blurred vision, the appearance of a “grid” before the eyes;
  • when looking at a bright light, “rainbow circles” appear before the eyes;
  • deterioration of vision in the evening and at night;
  • redness of the eyes.

If you have any symptoms, you should consult a doctor in order to prevent the disease in advance.

Treatment of glaucoma in adults

Medicines for this disease are ineffective, so it will not work to cure glaucoma at home. The most effective treatment for glaucoma is surgery. It will not be possible to return vision, but the operation will make it possible to prevent deterioration of vision, which threatens with irreversible blindness in glaucoma.

If a person has an open-angle form of glaucoma, then doctors most often perform an operation using the method of non-penetrating deep sclerectomy. During the operation, special miniature devices are inserted into the eyes, designed to perform the function of an alternative outflow of fluid in the event of an increase in intraocular pressure.

In angle-closure forms of glaucoma, both traditional surgical and laser operations are performed. If the size of the lens does not match the size of the eye, the method of removing the lens with simultaneous implantation of an intraocular lens is used. As a result of such microsurgical interventions, the natural circulation of fluid in the eye is restored, which makes it possible to prevent loss of vision.

Diagnostics

At an early stage, diagnosing glaucoma is almost impossible. When examining a patient, a thorough history is important. The doctor will definitely ask questions about whether close relatives have glaucoma. Then the examination begins with the measurement of intraocular pressure. More often, the maximum value of ophthalmotonus is noted in the morning hours (6-8 hours), the minimum – in the evening.

The maximum rise in pressure is observed in the daytime (12-16 hours), therefore, when examining a patient for glaucoma, it is necessary to measure IOP every 3 hours in a hospital for three days.

Repeated increase in normal pressure is one of the most important symptoms of glaucoma. Treatment is prescribed depending on the severity.

Modern treatments

In modern medicine, there is a non-penetrating deep sclerectomy – an antiglaucoma operation. It allows you to restore the natural balance of fluid in the eye with open-angle forms of glaucoma.

A feature of this operation is that to facilitate the outflow of fluid from the anterior chamber of the eye, through holes are not created, but the peripheral portion of the cornea membrane, which has natural moisture permeability, is surgically thinned.

This operation can also be combined with the implantation of special collagen drains, which prevent tissue scarring and reduce the effect of the operation in the future. It is performed without opening the eyeball.

The patient is quickly rehabilitated – one or two days, can start work in a few days, and he will not have serious surgical and postoperative complications.

Prevention of glaucoma in adults at home

“It is almost impossible to prevent glaucoma at home, so reducing the influence of risk factors can be considered the prevention of this disease,” says the doctor.

If you have problems with your eyes, vision, or have such people in your family, then:

  • you can’t overstress. This applies to both physical exertion and psycho-emotional;
  • don’t keep your head down. You need to keep your head straight at the computer, because it is harmful for people with glaucoma to engage in activities that require a long tilt of the head forward;
  • set the right lighting. You can not work, read, write in a room where there is poor lighting, because the eyes should not be overstrained;
  • give up bad habits. Smoking has an extremely negative effect on blood supply, and the transport of oxygen and nutrients to all elements of the eyeball is also disrupted;
  • prevent visual fatigue. After reading, working at the computer, allocate 10-15 minutes of rest.

Popular questions and answers

Comments Natalia Voroshilova, PhD, ophthalmologist.

Why, of all ophthalmic diseases, is glaucoma given so much attention?

This is a socially significant disease. Disability in glaucoma occupies one of the leading places, because glaucoma leads to an irreversible loss of visual functions in the form of a narrowing of the visual fields and a decrease in visual acuity.

Glaucoma has been getting younger lately, which means that the able-bodied population is beginning to suffer from this disease. Why so much attention is paid to it – because with early diagnosis, visual function can be preserved. Glaucoma cannot be cured, but it can be controlled and vision preserved.

Who is primarily at risk for this disease?

These are those people who have one parent or both at once suffered from glaucoma. They have a genetic predisposition to this disease. People with myopia are also at risk, the risk of developing glaucoma is higher in people with hypotension in their youth, because in hypotensive patients the blood supply to the optic nerve is worse throughout life. It can be regarded as a long-term hypoxia.

At risk for secondary glaucoma are people who have had inflammatory eye diseases, such as uveitis. Secondary glaucoma can be caused by long-term use of glucocorticosteroids (natural or synthetic drugs that have the properties of adrenal hormones – Ed.). They lead to increased eye pressure.

If symptoms appear too late, then how can you protect yourself from glaucoma?

Unfortunately, nothing can be returned, because glaucoma causes atrophy of the optic nerves, and there is no treatment for this condition yet. The only way to protect yourself from glaucoma is through early diagnosis.

To do this, first of all, you need to study your family history – if someone in your family suffered from glaucoma, if someone had poor eyesight, if you have nearsighted people in your family, then you need to treat yourself and your vision as carefully and as possible. age at least after 40 years to undergo ophthalmological examinations annually. In this case, it is necessary to measure intraocular pressure, look at the fundus and conduct a study of visual fields.

What is glaucoma surgery?

Surgery can be laser or microsurgical. The operation is the restoration of the drainage of the intraocular fluid, that is, under local anesthesia, the sclera is opened, access to the angle of the anterior chamber and help restore the flow inside the eye fluid.

During the operation, the outflow of intraocular fluid improves, the drainage pathways improve. Today, there are minimally invasive variations of glaucoma surgery that have a shorter healing period. It should be noted that after the operation, vision never improves, because the optic nerve has already been damaged, it cannot be restored.

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