20.04.2021

What is eye glaucoma

The human eye in its structure has 2 chambers between the iris and the cornea: front, back. These two chambers are communicated through the opening of the pupil; they contain aqueous humor – a transparent gel-like liquid. Watery moisture contains nutrients for the avascular parts of the eye: the lens, vitreous body, cornea.

The disease is characterized by a violation of the ratio of fluid produced in the eyeball and its outflow. This in turn leads to a slow increase in intraocular pressure and the development of complete blindness due to impaired microcirculation and atrophy of the optic nerve.

In normal circulation, ciliary cells produce a sufficient amount of fluid from the blood into the posterior chamber of the eyeball. From there, through the pupil, the fluid enters the anterior chamber and is disposed of using special drainage devices (channels) in the corner between the iris and the cornea.

The outflow and influx of aqueous humor, or rather its ratio, determines the norm of eye pressure – 18 mm RT. Art., which with glaucoma may not be impaired (glaucoma of normal pressure).

With a narrowing, which is more often observed in older people, or a complete blockage of the drainage system, fluid outflow does not correspond to its production, which provokes high eye pressure (IOP). This is what causes the development of eye disease.

High pressure in the chambers presses on the lens, which in turn presses on the vitreous body, behind which there is the choroid and the retina. Mechanical pressure on the blood vessels disturbs the nutrition of the retina, the visual cells gradually die. Over time, depending on how quickly the increase in pressure progresses, the entire optic nerve atrophies.

This eye disease is very insidious, as it is almost asymptomatic, up to the manifestation of the result of cell death by loss of peripheral vision. And at the same time, there may be a more rapid development option in the form of an attack and almost instant blindness. The course of the disease is determined by examination and depending on how the symptoms look.

Glaucoma classification

There are two main forms of the disease: open-angle and closed-angle. The difference is especially impaired outflow. In the open-angle form, the violation occurs due to the narrowing of the drainage channels, and in the closed-angle form, due to the closure of the angle between the cornea and the mechanically blocked outflow by the iris.

Types of glaucoma due to development:

1. Primary (pathology of the development of the eye structure):

  • congenital (juvenile, hydrophthalmus, butphthalmos);

2.  Secondary  (acquired):

  • age;
  • due to injury;
  • cornerstone;
  • steroidal;
  • after surgery and inflammatory diseases.

Varieties of stages (degrees) of eye pathology:

  • 1 degree – this is the stage of the initial stage. It is characterized by the absence of visual impairment, an increase in intraocular pressure to 26 mm RT. Art., the periodic appearance of rainbow rings in bright light.
  • 2 degrees – the development of the disease, IOP 26-32 mm RT. Art., the sharpness of peripheral vision is violated, the picture spreads around the edges.
  • 3 degrees – far-reaching glaucoma, at this stage there is a loss of visual fields, the picture looks like in a tunnel.
  • 4 degrees  – the terminal stage, partial vision remains with progression to blindness.

By the nature of the clinical picture:

  1. Prelaucoma is an episodic manifestation of a disease, which makes it difficult to detect such a disease.
  2. An acute attack  is a sharp increase in intraocular pressure amid complete blockage of the outflow. Without immediate medical attention guarantees blindness.
  3. Chronic course is a partial violation of the drainage system with the effect of a constant increase in IOP.

The degree of compensation is decompensated and uncompensated glaucoma, and the nature of IOP:

  1. Hypertensive – high intraocular pressure, the death of visual cells occurs due to compression and malnutrition.
  2. Antihypertensive – very low pressure, observed with vegetovascular dystonia (IOP), lack of nutrients due to low pressure in the bloodstream and poor microcirculation.
  3. Normotensive – intraocular pressure is normal, but cell nutrition is disturbed due to blockage or spasm of blood vessels, for example, with diabetes mellitus or atherosclerosis.

By age at which the eye disease was diagnosed:

  • up to three years old – congenital;
  • from three to ten years – infantile;
  • from 11 to 35 years old – juvenile (eye disease in adults).

According to the course of the disease:

  • stabilized – detected in time and maximally adjusted by medications;
  • unstabilized – advanced stage of eye disease.
Causes of Glaucoma

From what glaucoma happens, we found out above – this is intraocular hypertension, now we will consider the causes of high intraocular pressure.

Risk factors for developing glaucoma:

  • genetic predisposition to the disease;
  • damage to the eyes by injuries, tumors, chemicals, infectious diseases;
  • impaired refraction of the eye, hyperopia or myopia;
  • age, most often this eye disease appears from 40 to 60 years;
  • the ethnic reason associated with the small size of the eyeball among peoples of East Asian origin and the Eskimos;
  • prolonged use of steroids;
  • not operated on cataract on time;
  • diabetes, atherosclerosis and other diseases, including attacking vessels, including;
  • gender, women are more likely to develop this eye pathology, as they have 3 times less volume of the anterior chamber of the eye compared to men.
How does glaucoma manifest

Symptoms of glaucoma in adults depend on the form of the disease. The open-angle shape, unfortunately, is asymptomatic and the first signs are characterized by already irreversible changes.

Suspicion of glaucoma may cause:

  • periodic pain in one eye or in two;
  • redness;
  • flies;
  • rings shimmering with rainbow colors when looking at bright light;
  • tension, discomfort, eye fatigue;
  • lacrimation
  • feeling of tightness;
  • decreased visual acuity.

In the early diagnosis and examination of the fundus for the eye, a symptom of cobra is characteristic – expansion, tortuosity of the ciliary arteries. These symptoms with high intraocular pressure resembled the shape of a spectacle snake.

The number of characteristic symptoms of the disease is three – Greif triad:

  1. IOP increase.
  2. Progressive atrophy of the optic nerve.
  3. Gradual narrowing of the field of view.

The closed-angle form develops instantly in the form of an acute attack. A sharp blockage of the outflow provokes a rapid increase in intraocular pressure, which is accompanied by severe pain, loss of vision, nausea, vomiting, the eye becomes tense and hard, the temperature rises. Patients often perceive these symptoms for poisoning or other systemic diseases, it is precisely the loss of the field of vision in one or both eyes that should alert you. The elimination of the attack should be immediate, the time to irreversible degenerative changes is 2-3 hours.

Diagnostics

You must clearly understand that even an absolutely healthy person needs to do annual preventive examinations by an ophthalmologist. Regular eye examinations not only by visual, but also by hardware methods will help to diagnose the development of a latent disease in time.

Early detection of the development of glaucoma, assessment of the stage of damage is the key to the maximum preservation of vision. After all, this disease is incurable, doctors can only stop the progression or give a temporary panacea.

Diagnostics call a test for glaucoma, there are several types of them:

  • Tonometry is a measurement of intraocular pressure in both eyes.
  • Perimetry – determination of the boundaries of the field of view.
  • Ophthalmoscopy – examines the color, shape, structure of the optic nerve.
  • Optical tomography (OCT) of the optic nerve, an expensive but accurate examination, more about it can be found in the video:
  • Unloading / loading tests – an artificial increase in IOP to study the rate of return to normal. Used in the early diagnosis of pathology, there are tests: darkened, water-drinking, dark-drinking, midriostatic.
  • Pachymetry is a measurement of the thickness of the cornea.
  • Gonioscopy – studies of the angle between the iris and the cornea.

Electronic tonography is a long-term (about four minutes) study of ocular hydrodynamics. The IOP and the outflow velocity coefficient are measured, then the ratio of these values ​​is calculated – the Becker coefficient.

The study of the thickness of the layer of nerve optic fibers.

Glaucoma is only partially or temporarily curable. You can significantly suspend development and maintain the remaining level of vision at the time of detection of the disease. Glaucoma is not a sentence at all, the main thing is to recognize it in time.

Is it possible to cure glaucoma at home

Definitely not. Do not experiment with your own health, advanced forms of glaucoma threaten the complete extinction of visual cells and the lack of the ability to restore at least some vision.

Emergency care for an acute attack of a closed-angle shape should take place within a few hours and consist of finding a way to reduce eye pressure. In some cases, medical treatment will not be enough, then it is necessary to resort to urgent surgical intervention.

Drug treatment

The main cure for glaucoma is hypotensive drops. But remember that all existing anti-glaucoma drugs are just a symptomatic treatment that does not affect the restoration of the optic nerve.

In the complex, conservative treatment of glaucoma, tablets are also used (Hypothiazide, Proserin, Cavinton), vitamins (multicomplex) for the eyes, neuroprotectors, injections into the eyes, myotics (Pilocarpine, Carbachol).

Neuroprotection in glaucoma (Flupirtine, Dextromethorphan, Riluzole) affects the recovery of the consequences of the neurodegenerative effect of the disease. Treatment is aimed at preventing, reducing and reversing the process of nerve cell death, but this is possible with a fixed development of glaucoma.

Glaucoma injections are one of the most effective, quick methods of treatment. Manipulation is prescribed and carried out by a doctor. The drug is injected into adipose tissue, the eyeball, the vitreous, or under the conjunctiva.

The use of antidepressants to improve the general condition and reduce the risk of repeated exacerbations of the disease on nerve soil has also proven itself well. What antidepressants can be for you, only the doctor will say, do not self-medicate.

Physiotherapy

Physiotherapy is a conservative treatment, it normalizes and improves blood circulation in the optical system of the eye.

The main methods:

  • electrical stimulation;
  • magnetotherapy;
  • laser irradiation.

Activation of microcirculation contributes to better nutrition of the tissues and cells of the eye, as well as their rapid recovery and regeneration.

Surgery

Surgical treatment can be divided into radical and local. How exactly the treatment will occur depends on the stage of the eye pathology. Removing the consequences or glaucoma itself is impossible, have not yet come up with a way to restore the optic nerve, with the advanced stage of glaucoma, surgical removal of the eye (enucleation) is recommended.

Local treatment is most often performed with a laser and consists in temporarily providing an outflow of fluid.

Laser correction

Laser treatment involves several types of surgery:

  • Canaloplasty is a non-penetrating method that extends the drainage system of the eye with a catheter.
  • Sclerectomy is a one-time opening of the eye shell to drain excess fluid and reduce IOP.
  • Trabeculoplasty – the physiological restoration of the natural outflow of fluid, more in the video:

In addition, we recommend reading the article on glaucoma surgery.

Folk remedies in the treatment of glaucoma

Is it possible to restore vision after glaucoma folk remedies? Of course not, to return vision damaged by glaucoma will not work by any means. Any folk method should be approved by your ophthalmologist, do not risk your own health.

For the treatment of glaucoma, aloe (juice, broth, pulp), honey (honey drops), dill seeds (compress), sea duckweed (tincture) are mainly used.

New in treatment

Modern methods of treating glaucoma also do not yet provide the opportunity to completely get rid of this disease. If it were necessary to connect a couple of tens of wires during an eye transplant, the thing is in the hat, and there are millions of miniature nerve endings.

The latest method in treatment is an implanted mini-sensor. Fully autonomous, with a built-in battery and antenna, it is an intraocular pressure monitoring system with its constant measurement and information transfer to a computer.

But do not despair, according to recent studies, a group of Japanese biologists managed to reproduce retinal visual cells from stem cells. Now there is a process of studying the possibility of their introduction into the human eye.

What is dangerous glaucoma: prognosis

The most formidable consequence of glaucoma is optic atrophy and complete blindness. An undetected and neglected eye disease will gradually select the entire field of vision. Complications of glaucoma can not be treated – this is the path to disability.

Glaucoma Prevention

To understand how to maintain vision, read a series of the following prevention rules:

  1. Limit the use of tea and coffee – these products can increase intraocular pressure.
  2. Limitations also apply to salt, as it retains excess moisture in the body.
  3. Observe visual exercise and rest. Do not overwork your eyes.
  4. Perform simple exercises for vision.
  5. Visit your ophthalmologist periodically for a routine checkup.
  6. Do not lift heavy weights, avoid stressful situations.
  7. When working with visual stress, observe the rules of lighting and the distance to the object of attention.

Glaucoma, is it a disease or an age-related change? This is a violation of the normal functioning of the visual apparatus with the loss of certain fields of vision, up to its complete loss due to a violation of the outflow of intraocular fluid.

Glaucoma is also called green cataract due to the color of the cornea at the peak of exacerbation. This pathology develops asymptomatically and can completely deprive you of vision for a couple of hours after a migraine attack, regardless of age.

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