Glaucoma is a chronic eye disease in which pressure increases in the organs of vision. This leads to neuropathy, and over time, visual function is impaired. Symptoms of glaucoma include narrowing of the fields of vision, pain, pain, heaviness in the eyes. Pictures of the surrounding world are seen by the patient foggy, the ability to distinguish surrounding objects at dusk is greatly affected. Without adequate treatment, disease progression leads to complete blindness.
general information
If the patient is concerned about the symptoms that suspect glaucoma, it is necessary to undergo specialized examinations to confirm or refute the diagnosis. Doctors measure a person’s visual field, intraocular pressure, do tonography, tomography, gonioscopy, retinotomography. If the diagnosis is confirmed, the patient is prescribed special drops, it is recommended to undergo surgery. Currently, doctors have several different surgical procedures available that can restore health to patients with glaucoma.
Symptoms of glaucoma should be known to all modern people. Among ophthalmic, this disease is rightly considered one of the most dangerous and serious, since there is a possibility of complete loss of vision. According to statistics, glaucoma is diagnosed in 3% of the world's population. Up to 15% of the blind have lost the ability to see precisely because of glaucoma. Particularly careful should be those at risk for this disease: people aged 40 years and older. However, in recent years, glaucoma is increasingly found in adolescents, youth. Many cases of a congenital disease are known, on average, such an illness is diagnosed in one infant out of 20,000. But among people aged 40-50 years old, 0.1% of the population are ill with glaucoma. For 50-60 years, doctors give an estimate of one and a half percent, and for 75 years and older - more than 3%.
What is it about?
To understand why it is so important to notice the symptoms of glaucoma in time, it is worthwhile to first understand what the disease is. Pathology proceeds in a chronic form, while the pressure indicators in the organs of vision increase occasionally or are constantly maintained as such. Patients suffer from insufficient outflow of intraocular fluid. The study of the retina reveals trophic negative changes. At the same time, the optic nerve suffers. This leads to a defective field of view, doctors diagnose edge excavation of the disk element responsible for the vision of the nerve. Glaucoma is a precast concept. It includes about 60 pathologies that are characterized by the described features.
At present, it cannot be said that doctors know exactly why the symptoms of eye glaucoma develop. Studies show that several factors affect the formation of a disease at once. When aggressive phenomena overcome a certain individual threshold, a person becomes ill. The pathogenetic mechanism deserves the most attention. If the fluid inside the eye does not move along its intended paths at an adequate speed, the likelihood of illness is extremely high, because it is through this substance that metabolic processes are realized. At the same time, outflow disturbance leads to pressure instability.
Anatomy and pathology
For the normal functioning of the visual system, it is necessary that the ciliary body constantly generates moisture. This substance accumulates in the posterior ophthalmic chamber, a compartment resembling a fissure in shape. Most (up to 95%) flows through the pupil, appears in the anterior ophthalmic chamber and fills the space separating the cornea from the iris. The correct outflow is due to the presence of a natural drainage system in the anterior ocular chamber (in the corner). Drainage is formed by the trabecula, venous sinus of the sclera, provides fluid conductivity to the scleral veins. About 5% of the substance can penetrate the ciliary body and end up in special collectors of the ocular choroid.
If the inflow and outflow are in balance, the person is healthy and can see normally. With a violation, symptoms of the disease are observed. Glaucoma is accompanied by an excess of fluid in the eye cavities, which means that the pressure becomes higher than normal. This provokes a lack of oxygen, ischemic processes in the eye tissues. Dystrophic processes due to compression begin, degenerative changes encompass the nervous system. Ganglion cells suffer. The final stage is neuropathy, atrophy of the nerve fibers responsible for the person’s ability to see.
Everything is interconnected!
From birth, the signs and symptoms of glaucoma of the eye can be explained by abnormalities associated with intrauterine development, tumor processes, damage to the integrity of the visual organs. Acquired glaucoma is often diagnosed in persons among whose close relatives there were already patients with this pathology. The risk group includes diabetics, hypertension, patients with osteochondrosis of the cervical vertebrae, atherosclerosis.
Often the signs, symptoms of glaucoma of the eye of a secondary form are detected in people suffering from cataracts, occlusion, uveitis. The disease may appear in the background:
- hyperopia;
- atrophic processes of the iris;
- scleritis;
- keratitis;
- tumor process;
- injuries
- burns;
- iridocyclitis;
- hemophthalmus.
The risk of glaucoma is higher if a person has had surgery.
Types and Varieties
Symptoms, signs of glaucoma in different people can manifest themselves in different ways: a lot depends on the form of the disease. There are several parameters by which it is customary to divide pathology into categories. The simplest is primary. The disease can develop on its own, affect ophthalmic drainage, the anterior ocular chamber. The secondary form is a complication that develops against the background of various ophthalmic diseases (and other health disorders).
The mechanics of increasing pressure in the organs of vision allows us to divide all cases into two categories of glaucoma: open-angle, closed-angle. Symptom of glaucoma of the second type is a violation of the drainage of the eye, blocking the path of fluid outflow. The first option is that the corner of the camera is open, however, the intraocular fluid cannot move normally (other factors play a role).
Pressure indicators allow you to divide all cases into three groups:
- normotensive;
- hypertension
- high pressure.
In the first case, the tonometer shows about 25 mmHg, hypertension is estimated at 26-32 mm. Hg. Art., the third type of disease - a persistent increase in pressure above 33 mm. Hg. Art.
Glaucoma is stable - this is diagnosed if there is no negative dynamics when observing the patient for at least six months, and unstable when the fields of view are narrowed, the optic nerve gradually degrades.
Stages of the disease
There are four stages in total. The lightest is the first when the excavation of the optic disc has not yet spread to the edge, although expansion is present.
The second stage is marked by the adjustment of the central field of view, some segments are narrowed by 10 or more degrees, and the excavation becomes marginal.
At the third stage, the field of vision narrows concentrically, marginal subtotal excavation.
The fourth stage, terminal, is diagnosed if the patient has completely lost his vision or is only able to distinguish the presence and absence of light. Excavation of the optic disc is absolute, the vascular bundle is displaced, the neuroretinal girdle is destroyed.
Symptomatology
Significant symptoms of open-angle glaucoma are extremely rare. The field of view is gradually decreasing, but this process is very slow, takes years, and a person does not notice what is happening. At some point, the realization comes that the world is actually perceived only through one eye - and only at this stage the patient goes to the doctor. True, there are cases when the development of glaucoma was accompanied by blurred vision, the appearance of rainbow circles in front of the eyes. Some have a headache, aching over eyebrows. It happens that people pay attention to visual impairment in the dark. A distinctive feature of the open-angle shape is the defeat of two eyes at the same time. This is not always observed, but in a predominant percentage of cases.
It is somewhat easier to notice the symptoms of glaucoma in the early stages if the disease develops according to a closed-angle type. Before the disease itself, the preglaucoma stage is distinguished, after which the acute phase begins. It is followed by chronic. Prelaucoma does not manifest itself as symptoms, but it can be noticed during a preventive examination by a doctor. The doctor discovers that the corner of the anterior ophthalmic chamber is closed or substantially narrowed. Occasionally, a disease is accompanied by the appearance of rainbow circles in the field of vision at the time of birth. Perhaps a feeling of discomfort in the eyes and even a short-term loss of the ability to see.
Angle shape: disease progression
If the above symptoms of glaucoma in adults at an early stage did not appear or did not attract attention, the acute phase of the disease begins. At the same time, the corner of the anterior ophthalmic chamber closes, and the pressure rises to 80 units, sometimes more. Excessive fatigue, overstrain, emotional breakdown, drugs that affect the pupil, as well as prolonged exposure to the dark can provoke an attack. It is known that sometimes the acute phase of glaucoma was observed with a long stay in a pose with the head bowed.
If the symptoms of glaucoma in adults at an early stage did not attract attention, the acute one will manifest itself as a pain syndrome, a sudden weakening of the ability to see up to complete loss of vision - some say that they could only distinguish between light and darkness. The cornea fades, the pupil expands, and its color changes to greenish. Attacks are characterized by hyperemia of the eyes. Perhaps accompanied by nausea, heart and stomach pains. Some are dizzy, the pain responds in the area of the shoulder blades. To the touch, the eye becomes dense, as if stony.
The treatment of the symptoms of angle-closure glaucoma is possible only in a hospital setting. The patient must be hospitalized and take measures to reduce pressure in the organs of vision. You can use medications, but if this approach is ineffective, you will have to urgently do an operation. In the absence of adequate qualified help, the probability of irreversible blindness is high.
What's next?
The progress of the disease is associated with a transition to chronic pathology. In this case, the pressure in the organs of vision gradually increases, from time to time relapses are observed - subacute attacks. The angle of the anterior ophthalmic chamber is gradually blocked more and more. Such symptoms of adult glaucoma indicate that over time, the optic nerve will atrophy, and the person will go blind.
Establishing diagnosis
To begin timely treatment, the causes, symptoms of glaucoma should be the reason for going to the doctor. The sooner a disease can be detected, the better the prognosis. To do this, you must regularly visit an ophthalmologist to check the pressure in the eye, examine the eye day, and the nerve disc responsible for visual function. The doctor evaluates the patient’s field of vision, examines how well the angle of the eye chamber in front works.
Do not wait for the appearance of severe symptoms of glaucoma. Prevention of this disease, showing a truly reliable result - a regular examination with a doctor. To check the pressure indicators do elastotonometry, tonometry (single, during the day). To identify the features of fluid transportation in the organs of vision, electronic tonography is necessary.
If glaucoma is suspected, perimetry is necessarily done, during which it is determined what the boundaries of vision are for the patient. Use different techniques to obtain the most accurate result. Most popular:
- campimetry;
- isoptoperimetry;
- computer dimension.
Accurate perimetry helps to detect glaucoma symptoms at an early stage. The doctor may not be able to identify the causes of the disease in a particular case, but it will determine what measures need to be taken so as not to lose vision.
How to treat?
It was mentioned above that prevention is the best treatment for glaucoma symptoms. Unfortunately, it is not always possible to notice negative changes in the organs of vision in time. There are three main methods that are widely applicable to restore health in glaucoma:
- medicines
- laser surgery;
- classical surgery.
Choosing the most suitable way for a particular case will help the attending doctor. Much depends on the form: treatment for symptoms of open-angle glaucoma requires a slightly different than in the case of the second type.
When choosing drugs, measures are taken to lower blood pressure and stimulate blood flow to fully supply the nerve fibers with the necessary nutritional components. The normalization of metabolic processes in the organs of vision is an important stage in improving the patient's condition. There are special drops against glaucoma. In pharmacies, they are represented by three groups of drugs:
- stimulating fluid outflow (myotics, sympathomimetics, prostaglandins alpha-f-2);
- inhibitory fluid generation (alpha, beta-blockers);
- combined formulations.
Cases are different
Symptoms, causes, prevention of glaucoma - you can perfectly understand this topic, and yet one day encounter an attack of a closed-angle shape in the acute phase. If the patient’s condition is assessed in this way, the only way to maintain the ability to see is to urgently lower the pressure in the eye. The first drug measure is the instillation of a one percent solution of pilocarpine or timolol. At the same time, the patient is given diuretics.
An equally important aspect of first aid is distraction. Especially useful information about them is given to nurses, doctors as part of a course about the causes, symptoms, prevention, treatment of glaucoma. It is recommended to make mustard plasters, put banks. The patient will benefit from hot foot baths and leeches on the chest. To eliminate the situation of the corner block, to normalize the outflow of fluid, you will have to do an iridectomy using a laser system. An alternative is the classic surgical approach (basal iridectomy).
You can’t do without surgery
As can be seen from the relevance to modern medicine of topics related to glaucoma (causes, symptoms, treatment, prevention), the disease is severe, serious, its therapy requires specialized equipment, and the doctor must be highly qualified. In most cases, the patient is recommended to undergo a laser operation, and this requires a serious approach to choosing a reliable doctor. Modern patients have access to numerous methods and methods of operating the eye. There are lasers for:
In this case, the operation is carried out by the method of destruction or coagulation. The doctor, evaluating the patient’s condition, makes a decision whether to operate the iris or trabecula. Among the most popular approaches, iridectomy, iridotomy, iridoplasty, trabeculoplasty, goniopuncture are worth noting. If the condition is rated as very serious, cyclocoagulation using a high-precision laser is recommended.
Antiglaucomatous surgery is quite widely practiced. Among invasive methods, they are more often used:
- trabeculotomy;
- trabeculectomy.
Non-invasive approach - sclerectomy.
It is possible to normalize the circulation of intraocular fluid through iridectomy, iridocycloretraction. Reducing the volume of the produced substance is achieved by cyclocryocoagulation.
What to count on?
Glaucoma is a chronic disease. At the moment, medicine does not have access to techniques that can completely cure it. The main task of the patient is to control his condition, to be responsible for his lifestyle, to avoid factors that can provoke a relapse. The most positive prognosis in patients who turned to the doctor on time and found pathology at an early stage. Satisfactory therapeutic results can be achieved. Lack of treatment, uncontrolled progress - a guarantee of vision loss.
To prevent the disease and notice it in time, you need to regularly visit a doctor to assess the fundus and visual fields. – , , 40- . , , . , , . , , , . , . , , .
To prevent glaucoma, it is necessary to use dietary supplements. They are recommended if the disease is already established. The choice of vitamins and minerals should be agreed with your doctor. The pharmaceutical industry produces a wide variety of products containing components that are useful for human vision. If a doctor prescribes medication, usually in addition to it, active ingredients are prescribed to improve the nutrition of eye tissues. Lutein-containing formulations are especially widespread. As an independent treatment, such drugs are not applicable, but significantly increase the effectiveness of the main course. With an increased risk of glaucoma, the use of food additives allows you to ensure a healthy present and future, preservation of vision for many years. Among the most popular products:
- "Lutein Complex."
- "Blueberry Forte."
- Vitrum Vision.
Drops for glaucoma
Eye drops from the category of prostaglandins recommended by patients with glaucoma are based on hormonal compounds. When prescribing the medicine, the doctor warns of possible side effects: the eyes may redden, the iris may darken. Perhaps a change in the color of eyelashes, tingling in the eyes. Sometimes objects are seen blurry. The most popular formulations:
Beta blockers are no less effective, but can also be a source of side effects. Among other things - decrease in pressure, decrease in heart rate, chronic fatigue. Possible violation of sexual function. Popular remedies:
Carbonic anhydrase inhibitors are infrequently used agents that help reduce the activity of cells responsible for the production of intraocular fluid. Such can cause frequent urination, tingling of the extremities, and a taste of metal in the mouth. Known funds are Azopt and Trusopt.