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Glaucoma – a serious chronic illness of an eye which is characterized by the increased intraocular pressure (VGD). At the same time the optic nerve is surprised, sight decreases and approach of a total blindness is possible. The optic nerve completely perishes, and the blindness has irreversible character.
Unfortunately, glaucoma is rather widespread, aged people have it is more senior than forty years. According to WHO data, in the world the number of glaukomny patients reaches 100 million people. At younger age glaucoma meets much less often.
Intraocular pressure increases on two basic reasons: formation of intraocular liquid in excessive quantity and disturbance of removal of intraocular liquid by drainage system of an eye. The delay of intraocular liquid causes increase of VGD, and high VGD leads to death of an optic nerve and a blindness. However, from what there is an excessive formation of liquid while it is unknown. It is considered that the huge role in developing of glaucoma is played by hereditary factors. If in a family there are relatives who had glaucoma it is necessary at least once a year to pass survey at the ophthalmologist.
The neglect treatment at glaucoma inevitably leads to a blindness.
Distinguish several kinds of glaucoma:
Inborn glaucoma which can be caused by the genetic reasons or diseases and injuries of a fruit during the periods of embryonic development or childbirth. Inborn glaucoma is shown in the first weeks of life. The disease rather rare — is the share of 10-20 thousand newborns only 1 case of glaucoma.
As cause of illness heredity of autosomal and recessive type most often acts. At the same time anomalies of an eyeglobe are observed. Impacts on a fruit of such diseases as a clumsy rubella, flu, a toxoplasmosis, parotitis, hypoxias can be the reasons also.
Juvenile or juvenile glaucoma. Develops at children after three years and young people to 35-year age. Inborn changes in an eye iris of the eye are causes of illness.
Secondary glaucoma is a consequence of other eye or general diseases at which the eye structures which are responsible for circulation and outflow of intraocular liquid from an eye are surprised. Mechanical injuries of an eye can also be the reasons.
Primary glaucoma of adults – the most frequent type of chronic glaucoma which is connected with age eye changes. The illness is divided into 4 main clinical forms: an open angle glaucoma, the mixed glaucoma, closed-angle glaucoma and glaucoma with normal VGD.
Glaucoma symptoms directly depend on a form and a stage of a course of a disease. Her insidiousness is that at an initial stage of a disease, 80% of patients do not feel any discomfort. What has to guard:
- Symptoms of glaucoma of primary type or as it is called still, primary glaucoma, that is one of forms closed-angle or an open angle glaucoma, it is iridescent circles. At a view of a bulb or a flame of a candle, it seems to the patient that fire is surrounded with an iridescent aura.
- Emergence of "grid" before eyes, the pressing pains in an eye sometimes giving to the head.
- Periodic "misting" of sight, emergence of "veil", most often in the mornings, decrease in visual acuity in twilight also belongs to symptoms, and then and at normal lighting, narrowing of a visual angle.
- At survey by the specialist hypostasis of a cornea and iris of the eye of an eye is observed.
- Measurement of pressure shows the increased values, the patient feels sick.
Inborn glaucoma at children is shown by stretching of a cornea which is elastic at newborns and accepts the normal sizes after the first week of life. At glaucoma of an eye also more norms seem more expressive. It leads to stretching and thinning of a retina and its further peeling with gaps.
The myopia or miopichesky astigmatism, slight increase of intraocular pressure at early stages of a disease are observed. There is cornea hypostasis that leads to deterioration in sight, and further it is connected with an atrophy of an optic nerve and deformation of an eyeground.
Treatment of glaucoma
The main objective in treatment of glaucoma is preservation of visual functions with the minimum side effects from the applied therapy and maintenance of normal quality of life of the patient. Guarantee of successful treatment is the correct understanding the patient of the serious forecast of an illness and need of adequate treatment.
Treat glaucoma by a conservative (medicamentous) method, in a laser and surgical way. Drug treatment, in turn, is carried out in three directions: oftalmo-hypotensive therapy – the measures directed to decrease in intraocular pressure. The measures directed to improvement of blood supply of internal eye covers and intraocular part of an optic nerve. Normalization of a metabolism (exchange processes) in eye fabrics for impact on dystrophic processes which are characteristic of glaucoma. Symptoms of glaucoma and its complication are stopped.
Earlier Pilocarpinum, the drug narrowing an eye pupil was applied to drug treatment of glaucoma. Now it was succeeded by new drugs: Betoptik, Betadin, Timololum, Trusopt, Ksalatan and some other. The latest drugs allow to carry out impact on glaucoma more directionally: to reduce products of liquid and to improve its outflow.
Laser treatment became possible not so long ago, after creation of modern ophthalmologic laser machines with a certain set of parameters which influence structures of an eyeglobe. It allowed to develop and apply the most various techniques of laser treatment of glaucoma.
Laser treatment of glaucoma has a number of advantages: first, low injury of procedure, secondly, total absence of serious complications which can arise during the postoperative period, thirdly, a possibility of carrying out treatment in out-patient conditions that significantly influences economy, a possibility of carrying out, if necessary, repeated laser interventions, at essential decrease in hypotensive effect in the postoperative period.
Laser treatment of glaucoma is carried out by the following techniques:
- laser trabekuloplastika;
- laser corectomy;
- laser gonioplastika;
- laser trabekulopunktura (outflow activation);
- laser destsemetogoniopunktura;
- laser transscleral cyclophotocoagulation (contact and contactless).
Surgical treatment consists in creation of alternative system of outflow of intraocular liquid then there is a normalization of intraocular pressure without use of medicamentous drugs.
Various forms and types of glaucoma assume distinction of a surgical operative measure and are solved, every time, individually. An exception is inborn glaucoma at children, this form of a disease is treated only by surgical methods.
Prevention of glaucoma
Glaucoma is, perhaps, the most common reason of a blindness and therefore prevention of progressing of a disease has huge social and economic value both for the certain person, and for society in general.
Disease in many respects depends on way of life of the diseased, treatment of glaucoma cannot be successful without correction of way of life. It is necessary to avoid physical and nervous overworks, especially at advanced age. Admissible extreme weight for a raising should not exceed 10 kg. It is, also, not necessary to read at bad lighting and during the long period.
Also the diet is of great importance, it is necessary to eat rationally, according to age. The preference should be given to vegetable dishes, fish, crude vegetables and fruit and to limit reception of animal fats and sugar. Nicotine therefore, it is better to refuse smoking, the quicker, the better is very harmful to eyes.
The most effective in prevention of a disease of glaucoma, is systematic survey at the specialist ophthalmologist and control of intraocular pressure, for persons, 40-45 years are more senior. It is necessary to visit the doctor at least, than once a year. Especially people who have relatives sick with glaucoma have to show consideration for questions of prevention of glaucoma.
In a case when the first symptoms of glaucoma appeared, it is necessary to see a doctor immediately. At detection any form of glaucoma needs to be surely on dispensary observation at the doctor-oculist. Remember that now the medicine has no opportunity to recover lost as a result of progressing of glaucoma, sight.
Section: Diseases of eyes