Glaucoma is an eye disease that leads to damage to the optic nerve and loss of vision due to increased intraocular pressure. It is often referred to as the "silent disease" because in most cases the disease develops slowly and asymptomatically.
Elderly people are at increased risk, but regular check-ups with a doctor and timely therapy can help avoid irreversible consequences. The earlier the diagnosis is made, the more possible treatment options for glaucoma. In order to choose the right treatment course, it is necessary to determine what type of glaucoma the patient suffers from, as well as the stage of development of the disease.
How is it developing?
Every adult should know what glaucoma is, its causes, methods of treatment and prevention. To understand how glaucoma develops, you should be familiar with the structure of the eye. Between the iris and the cornea is a gap called the anterior chamber. It contains a fluid that continuously circulates, nourishing the tissues of the eye. Fluid leaves the eye chamber at the point where the cornea meets the iris, forming an angle. Reaching the corner, moisture penetrates into the spongy system of drainage tubules,then into the bloodstream.
Some people don't have this kind of circulation. The eyes produce too much moisture, or the tubules in the angle are narrowed and fluid accumulates in the chamber. It creates constant high pressure. Left untreated, it causes damage to the optic nerve and loss of vision.
What are the symptoms?
The symptoms of glaucoma vary, depending on the type of glaucoma. If the drainage angle is open, but the outflow of fluid is impaired, this is open-angle glaucoma. It is this type that affects people in 90% of cases. Its symptoms are difficult to detect because it develops very slowly, over several years. Usually, open-angle glaucoma is diagnosed when there has already been a significant decrease in vision. That is why it is so important to have regular check-ups with a doctor.
Symptoms of open-angle glaucoma:
- Violation of peripheral vision. At first, patients notice the appearance of dark spots with peripheral vision. Eventually, without treatment, peripheral vision will disappear completely.
- Tunnel vision. When peripheral vision is reduced, a person begins to see only what is directly in front of him, as if peering into the light at the end of the tunnel.
- Blindness. The final stage of the disease is complete loss of vision.
Other shapes
Although open-angle glaucoma is the most common, there are other forms of the disease.
Angle-closure glaucoma results from blockage of the iriocorneal angle. In this case, liquid cannot pass through the drainchannel, accumulates in the anterior chamber, and the pressure increases greatly. A possible cause could be inflammation of the iris or an eye injury. Symptoms develop rapidly and it is important to have time to start treatment before complete loss of vision.
Symptoms of angle-closure glaucoma:
- Nausea.
- Headache.
- Pain in the eyes.
- Blurred vision.
This type of glaucoma needs surgery to open the drainage pathways and relieve pressure. Surgeons usually correct the affected iris to allow normal circulation.
Normal pressure glaucoma
Despite the previously indicated causes of the disease, sometimes damage to the optic nerves occurs against the background of normal pressure. The patient experiences almost no discomfort until a significant visual impairment occurs. The cause of this disease is especially sensitive optic nerves, which are susceptible to damage even under normal pressure. The main goal of treating this type of glaucoma, as in the case of open-angle glaucoma, is to maintain low eye pressure.
Secondary glaucoma
It can develop as a complication of other diseases such as cataracts, trauma, inflammation, etc. Pigmentary glaucoma is a type of secondary glaucoma that occurs when pigment from the iris sloughs off and blocks the tubules, slowing fluid drainage. Another severe form, called neovascular glaucoma, is associated with diabetes. Corticosteroid drugs used to treat eye inflammation andother diseases can also cause glaucoma in some people. Treatment varies depending on the underlying cause and may include medication, laser or conventional surgery.
Who is at risk?
Anyone and at any age has a chance to get glaucoma. However, there is a certain group of factors that increase the likelihood of developing the disease. These include:
- Older people over 60. Are at high risk due to possible associated he alth problems that indirectly provoke the appearance of glaucoma.
- Eye injury. Can lead to occlusion of the iriocorneal angle even years after injury.
- Cornea thickness. Studies have shown that with a cornea thickness of 555 microns and high pressure, the development of glaucoma is 6 times more likely than with the same pressure and a thickness of more than 580 microns.
- Diabetes and heart problems. They increase the chance of developing glaucoma, so it is necessary to carry out parallel treatment of two diseases.
Diagnosis of glaucoma
Given that increased eye pressure is not the only factor provoking the onset of the disease, a number of different tests are carried out for proper diagnosis:
- Tonometry measures eye pressure. Normally, its value should be in the range of 12-22 mm. rt. Art. Tonometry should be carried out at each visit to the ophthalmologist. Measurement of pressure by the Maklakov contact method occurs according to the following algorithm:an anesthetic, usually "Lidocaine", then weights coated with a special coloring composition are applied to the patient's cornea. The same is done with the second eye. Then the weights are leaned against alcohol-impregnated paper and the result of the analysis is determined by the diameter of the prints. The patient is instilled with a disinfectant composition.
- Ophthalmoscopy is needed to check the optic nerve. The patient is in a dark room, and the doctor uses a special tool with a light bulb. This procedure helps to assess the condition of the inner membranes of the eye, the color and condition of the optic nerve, etc.
- Gonioscopy is performed in case of complaints of poor vision, even if the pressure is within the normal range. This test determines the degree of angle between the cornea and the iris to identify the type of glaucoma.
- The perimetry test is carried out by a device with flashing lights. The person looks straight ahead and indicates which of the indicator lights they see. The test determines the "map" of vision, highlights blind spots.
Treatment of glaucoma of the eye
There is no cure for glaucoma, and complete loss of vision cannot be restored. Immediate treatment at an early stage can delay the progression of the disease. That is why early diagnosis is very important.
Glaucoma treatment may include medication, laser trabeculoplasty, conventional surgery, or a combination of these. Treatment may save the remaining vision, but it will not repair the damaged nerve. If the patient is completely blind due to glaucoma, surgery will not help.
Drugs
Medication in the form of eye drops or pills is the most common way to stop the disease. Some medications cause the eyes to produce less fluid. Others lower the pressure by slightly expanding the drainage channels and allowing moisture to circulate. Before starting glaucoma treatment, older people should inform the ophthalmologist about all medications used, as eye drops may not be compatible with other medications.
Taking drops several times a day usually does not bring any inconvenience. However, in some cases, medications can cause headaches or other side effects (such as burning and redness of the eyes).
Laser trabeculoplasty
The treatment of glaucoma by surgery is considered a necessary measure if the disease progresses rapidly. Laser trabeculoplasty helps flush fluid from the eyes. Your doctor may suggest this step at any stage of your treatment. After this procedure, the use of drops does not stop.
Before the operation, the eyes are instilled with a local anesthetic. The patient sits facing the laser machine, and the doctor sets up a special lens. A high-intensity beam of light directed at the lens is reflected on the retina inside the eye. The patient may see flashes of bright green or red light. The laser makes several evenly spaced microburns that stretch the drainage holes in the mesh structure. This procedure allows the liquid to drain better. Like any operation,laser surgery can cause side effects. After the operation, the doctor prescribes drops to disinfect the cornea. The procedure for laser treatment of glaucoma is performed on an outpatient basis. It will then take several more visits to the doctor to control eye pressure.
If glaucoma has affected both eyes, the operation is performed alternately, first on one, then on the other, with a break of several days to 2 weeks. During this period, the patient may experience tingling, photosensitivity, and slight blurred vision.
Despite the simplicity and painlessness, laser treatment of glaucoma is not always effective. Approximately 12% of patients need reoperation after a few years.
Conventional surgery
During a surgical operation, the doctor works manually, making a hole for the outflow of fluid from the eye. Usually, surgery is prescribed when drugs and laser treatment of glaucoma have not helped to reduce pressure. In addition, such a procedure is applied when the reason for the deterioration of vision is the closure of the iridocorneal angle.
Surgery is performed in an eye clinic or hospital. Before the surgical treatment of glaucoma, the doctor makes injections around the eyes for anesthesia. A small piece of tissue is removed to create a new channel for fluid to drain from the chamber.
For several weeks after surgery, the patient should use drops to prevent infection and inflammation. As with laser glaucoma treatment, conventional surgeryperformed first on one eye. The subsequent break can last 3-6 weeks. The effectiveness of the procedure is 60-80%, but this percentage decreases with the surgical treatment of glaucoma in the elderly. With age, there is a high probability of having chronic diseases that will aggravate dystrophic processes. In 50% of cases, these patients will need to repeat the procedure within 2-5 years.
Surgery to treat glaucoma is most productive if the patient has not previously had any surgical interventions, such as cataract treatment. In some cases, after the procedure, vision is reduced. Conventional surgery can cause side effects, including rapidly developing cataracts, corneal problems, inflammation, or eye infection. When fluid accumulates in the posterior chamber, a person sees shadows and dark dots.
Glaucoma prevention
Because the disease often develops with age, regular eye examinations are the best prevention. People over 45-50 years old should visit a doctor at least 2 times a year, even in the absence of he alth complaints. Among the factors that increase eye pressure, fatigue is distinguished. Treatment of glaucoma in the elderly is more effective if they observe the alternation of work and rest, do not allow increased eye strain. You should not read in the twilight and is in front of a TV or computer for more than 3 hours a day. Bright light is dangerous for the eyes, so in summer and snowy winter it is worth wearing glasses with tinted lenses. Frequent cinema visits are also discouraged.
Incorrect head position can cause fluid to flow into the anterior chamber of the eye, so do not throw back or tilt your head, for example, when working with small parts. In addition, increased fluid content in the body can lead to increased excretion of moisture, so it is worth limiting yourself to a few glasses of water per day. Strong drinks and energy drinks provoke vasoconstriction, which adversely affects vision. It is not recommended to eat foods with a lot of s alt and spices.
Especial care should be taken to protect the eyes from injury and damage. Always wear safety goggles when doing construction work, as eye injury is often the cause of secondary glaucoma.
Therapeutic exercises for the eyes
A useful and affordable way to treat and prevent glaucoma will be massage and gymnastics. In order to accelerate the outflow of moisture from the eye chamber, you can massage the upper eyelid several times a day with light pressure in a circular motion. Equally effective is a head and neck massage to improve blood flow.
Exercise for eye he alth reduces tension in the eye muscles and restores the functioning of the vascular system. Gymnastics should be done 1 time per day for about 5-10 minutes in the following sequence:
- Close your eyes for a couple of minutes and try to relax and bring your breathing back to normal.
- Select a point at a considerable distance, stop looking at it, and then move it to the tip of the nose. Consistently look at the far and near point at least 10 times.
- "Draw" with a glance in the air, first a figure eight, and then an infinity sign 5 times, first in one direction, then in the other direction.
- Keep your head straight and look up then down at least 10 times.
Folk treatments for glaucoma
Decoctions of various herbs help reduce eye pressure, have anti-inflammatory properties, and also contain vitamins that help remove excess fluid from the body.
According to numerous reviews, the treatment of glaucoma in the complex significantly increases the chances of maintaining vision.
Recipe 1: You need to take 2-3 tbsp. spoons of corn stigmas and insist them in a glass of boiling water for 2 hours. Take a tablespoon 30 minutes before meals. Acts as a diuretic, removes fluid.
Recipe 2: Mix a few chopped birch leaves, elderberry and horsetail. Infuse a teaspoon of the collection for about an hour in a glass of boiling water. Drink a quarter cup in the morning before meals. The course should last from 1 to 3 months. The composition is used to improve blood circulation.
Recipe 3: Common chamomile has a pronounced anti-inflammatory effect. Eyes should be washed with strained infusion at room temperature. To prepare it, take 1 tbsp. a spoonful of chamomile flowers and pour 200 ml of boiling water. Let it brew in a sealed container for about an hour.
Recipe 4: Arnica tincture is used to strengthen the optic nerves,which can be purchased at any pharmacy. Add 3-5 drops of tincture to a teaspoon and drink before meals 2 times a day. The course should not last more than 4 months.
Of course, alternative treatment of glaucoma cannot completely replace the standard one.
Constant monitoring of your own he alth and regular visits to the optometrist is the best way to preserve your eyesight, especially in adulthood. Glaucoma is an insidious disease that often resolves without symptoms. If a person is at risk or has had a family history of glaucoma, advice on prevention, treatment, and causes of glaucoma should be followed.
