The causes of glaucoma

Eye pathologies are mostly divided into two large groups: infectious and age-related. The first group of diseases can develop independently of the patient's age and is directly related to the level of immunity. But age changes are characteristic only for people of elderly and senile age and more often they are irreversible. Among these diseases is glaucoma, one of the main signs of which is damage to the optic nerve.

Definition of disease

The human eye is a complex optical system consisting of many elements. One of the most important is the optic nerve, through which the visual image from a specific area of ​​the retina (macula, or yellow spot) is transmitted to the brain.

The eyeball inside is filled with a kind of biological gel (vitreous body), having a certain density and volume.During the life of its composition is constantly updated: the eye produces a new liquid, and the excess is allocated in the form of eye moisture through the drainage system in the area of ​​the anterior chamber of the eye.

If there is a disruption in the functionality of the drainage system, the pressure inside the eye begins to rise and, as a consequence, the intraocular fluid begins to press on the optic nerve.

Over time, atrophy of the optic nerve develops, impulses that enter the brain are weakened, and visual acuity is reduced, sometimes to complete blindness.

Causes

The disease can develop both because of increased IOP, and at its normal rates, however, as a rule, increased IOP always leads to optic atrophy. There are several types of disease:

• Primary. This type of glaucoma affects people after 40 years and is most often due to natural changes in tissues. In this case, provoking factors are strong nearsightedness, old age, pathological conditions in the nervous and endocrine systems, heredity, high blood pressure, etc. ;
• Congenital. This type of disease is caused by eye anomalies that occurred during the period of intrauterine development, or eye diseases of different etiology, appearing in the mother shortly before or at the time of passage childbirth;
• Secondary. The disease develops as a complication of the transferred disease: inflammatory or dystrophic ocular pathologies, cataracts, traumas or neoplasms of the eyes, surgical treatment.

The greatest likelihood is also susceptible to persons with low blood pressure and used in the treatment of drugs with hormonal components.

Symptoms

Depending on the degree and form of disturbances in the functioning of the drainage system, the eye distinguishes two forms of the disease:

• Open angle.The disease is characterized by an almost asymptomatic course and can remain latent for years. Sometimes there may be symptoms such as fogging, iridescent halos around lanterns or light bulbs, dark adaptation decreases, but IOP increases necessarily. At the same time, there is a gradual deterioration in visual acuity, and often patients get to a medical appointment at an advanced stage of the disease;
• Closed-angle.If the open-angle form is diagnosed in most (up to 80%) cases, the closed-angle form is only 1/5 of all the diseases, but its symptoms are much heavier. In this case, the outflow of intraocular fluid is disturbed due to the fact that there is no access to the drainage system of the eye - it is blocked by the iris. Characteristic is the paroxysmal course of the disease, when the symptoms are aggravated: sharp eye and headache, visual acuity, reddening of the conjunctiva. The attack requires immediate medical or even surgical care.

Glaucoma of the eye can develop both in high and normal IOP, but increased IOP is usually a symptom of the onset of the disease. In this case, it is necessary to constantly monitor it in order to start treatment in time. The main symptom of glaucoma is narrowing of the visual fields - this indicates the beginning of functional changes in the optic nerve.

Possible complications

In terms of severity, the disease has not only the first (open-angle) and second (closed-angle) stages, but also more serious forms:

• Mixed, which is characterized by a constantly high IOP;
• Terminal, characterized by a strong pain syndrome.

When untimely or incorrect treatment of glaucoma in patients develops a tubular vision (strong narrowing of the visual fields) and complete blindness.

If, at the terminal stage, lesions of the optic nerve are accompanied by a constant pain syndrome, the only way out is to remove the diseased eye.

Treatment

For the beginning of medical procedures the doctor appoints a number of mandatory examinations:

• Visometry;
• Perimetry;
• Campimetry;
• Biomicroscopy;
• Gonioscopy;
• Tonometry;
• Ophthalmoscopy.

In addition to these methods, coherent tomography of the retina, rheophthalmography, stress tests are used, as well as laboratory blood tests and specialist consultations. This is done to identify the causes that can provoke the development of the disease.

Medication Therapy

Conservative treatment is effective at an early stage of disease detection, however, it does not guarantee a complete cure, but only inhibits the progression of the process.However, the regular use of drops by the patient and the constant monitoring of IOP can select the most effective drugs and stop the development of glaucoma for many years. At the same time, constant preventive examinations are required from an ophthalmologist: first the efficacy of the prescribed medication is checked by the doctor within 2-3 weeks, then enough consultation every 3 months. After 1-2 years, the drugs should be changed, because the body gets used to their action.

In drug therapy, two groups of drugs are possible: increasing the outflow of intraocular fluid and lowering its production. As a result, in both cases there is a decrease in IOP.

In the treatment of possible prescription of drugs from the following groups of medicines:

• Myotics: Pilocarpine hydrochloride, Oftanpylocarpine, Isopto-carbachol. These agents effectively improve the removal of intraocular fluid, affecting the ciliary muscle and trabecular network;
• Sympathomimetics:Glaucon, Epinephrine, Oftan-dipivevephrine. The action of this group of drugs is also aimed at increasing the outflow of intraocular fluid;
• Prostaglandins F₂ alpha: Xalatan, Travatan. Preparations of this group improve the uveoscleral outflow pathway;
• Beta-blockers: Oftan timolol, Timogeksal, Kuzimolol, Betaxolol. The funds of this group of drugs inhibit the production of intraocular moisture;
• Inhibitors of carbonic anhydrase: Trusopt, Azopt. Reduces the secretion of aqueous humor by inhibiting carbonic anhydrase in the ciliary body;
• Combined:Proxopheline, Fotil, Kosopt and others. Combine the properties of both groups and have a more pronounced effect.

  Trusopt is used in the treatment of glaucoma

All medicines are divided into drugs of the first and second rows. First-line drugs are prescribed at the beginning of therapy and, when successful, are used in treatment. In the case of adverse effects, a second-line remedy is chosen. The treatment of glaucoma is a complex and lengthy process, therefore self-medication is unacceptable here. The choice of a suitable medicine is made only by the doctor taking into account the individual characteristics of the patient's health.

Surgically

Treatment with the use of operational techniques is carried out in the case when conservative measures do not give a result.To date, according to some surgeons, this is the only correct way to eliminate the pathology, because sometimes conservative treatment not only helps, but also aggravates the situation.

However, the operation, even the most innovative, is still an operation. And she has a number of contraindications, and also complications are not rare. Sometimes even after the surgical intervention, there is a need for treatment with medications.

In modern ophthalmologic practice, the following methods of surgical intervention are used:

• Laser iridectomy- a laser creates an opening in the outer edge of the iris;
• Laser trabeculoplasty- used to treat open-angle glaucoma by restoring the drainage function of the trabecular network;
• Laser ziorioablation- the laser destroys part of the ciliary body (the structure that produces the intraocular fluid);
• Trabeculectomy- removing part of the drainage system to restore its functionality. The most frequently used type of surgery;
• Shunt devices- implantation in the eye structure of micro devices, which allow to restore the drainage system;
• Viscochannelostomy- the essence of the operation is to remove a small part of the sclera, as a result of which drainage occurs through the remaining thin shell. The least effective type of operation, however, is also the safest.

  Laser iridectomy

Before the operation, the patient is assigned a full examination, since it can be done only in the absence of contraindications.

Folk remedies

Treatment with medicines based on folk recipes can greatly improve the effectiveness of drug therapy and have a positive effect on metabolic processes in the eyes:

• Before each meal, a glass of tomato juice is drunk with the addition of 1 tbsp. l. honey;
• Make a decoction of equal parts of currant leaves, spring primrose, berries of aronia and ashberry grass. In 200 ml of boiling water add 1 tbsp. l. decoction and insist, h. in a dark place. Drink during the day;
• Blend of blueberries in half with honeytake constantly 1-2 tbsp. l. in a day;
• Fill1 hour l. fennel seedsa glass of boiling water, boiled for several minutes, insisted for an hour and filtered. Take ¼ cup three times a day before meals. The course of treatment is 21 days. Repeat the course after a 10-day break;
• Make infusion from 1 h. l. herbs anise in 100 ml of boiling water, insist and wash the eyes 3-4 times a day.

Try to prepare every day a fresh medicine, and before using, be sure to consult a doctor.

Prevention

Glaucoma in most cases is the result of age-related changes, so the first rule of prevention - careful attitude to the eyes, elimination of overloads for the eyes and the whole body, avoidance of the inclined posture at work, as well as mandatory preventive examinations at the ophthalmologist.

Observe age limits in the diet: food should be easily assimilated and in appropriate treatment, with a minimum of carcinogens and food additives.

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Side effects of orthokeratological lenses

Luxifen eye drops with instructions and indications for use are presented here.

All about laser operation on eyes by a technique of Lasik it is written here.

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Video

conclusions

With timely and regular treatment, the symptoms of glaucoma progress slowly, so you can keep your eyesight for many years. As a last resort, to have an operation.

However, for a favorable outcome, continuous monitoring of visual acuity and measurement of IOP is necessary. Therefore, in the elderly, an annual ophthalmological examination is recommended.

Read also about the causes of episcleritis and why there are yellow circles under the eyes.