Glaucoma is a chronic eye disease in which pressure increases in the organs of vision. This leads to neuropathy, visual function is impaired over time. The symptoms of glaucoma include narrowing of the visual fields, pain, pain, heaviness in the eyes. Pictures of the surrounding world are seen by the patient as foggy, the ability to distinguish surrounding objects at dusk suffers greatly. Without adequate treatment, the progression of the disease leads to total blindness.
General information
If the patient is concerned about the symptoms of glaucoma, it is necessary to undergo specialized examinations to confirm or refute the diagnosis. Doctors measure the field of view of a person, intraocular pressure, do tono-, tomography, gonioscopy, retinotomography. If the diagnosis is confirmed, the patient is prescribed special drops, it is recommended to undergo surgery. There are currently severaldifferent methods of surgical intervention to restore he alth to patients with glaucoma.
Symptoms of glaucoma should be known to all modern people. Among ophthalmic diseases, this disease is rightfully considered one of the most dangerous and severe, 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. Particular attention should be paid to persons included in the risk group for this disease: people aged 40 years and older. However, in recent years, more and more often glaucoma occurs in adolescents and young people. Many cases of a congenital disease are known, on average, such a disease is diagnosed in one baby out of 20,000. But among people aged 40-50, an average of 0.1% of the population suffers from glaucoma. For 50-60 years old, 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, you should first understand what the disease is. The 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. When examining the retina, trophic negative changes are revealed. At the same time, the optic nerve suffers. This leads to a defective field of view, doctors diagnose marginal excavation of the disc element.the nerve responsible for vision. Glaucoma is a collective concept. It includes about 60 pathologies, which are characterized by the described features.
Currently, it cannot be said that doctors know exactly why the symptoms of glaucoma develop in the eye. As studies show, several factors influence the formation of the disease at once. When aggressive phenomena overcome some individual threshold, a person becomes ill. The pathogenetic mechanism deserves the greatest attention. If the fluid inside the eye does not move along the paths intended for it at an adequate speed, the likelihood of illness is extremely high, since it is through this substance that metabolic processes are realized. At the same time, the violation of the outflow leads to pressure instability.
Anatomy and pathology
For the normal functioning of the visual system, it is necessary that the ciliary body constantly generate moisture. This substance accumulates in the posterior eye chamber, a compartment shaped like a slit. Most (up to 95%) flows through the pupil, enters the anterior chamber of the eye and fills the space separating the cornea from the iris. Proper outflow is due to the presence of a natural drainage system in the eye anterior chamber (in the corner). The drainage is formed by the trabecula, the venous sinus of the sclera, which ensures the conduction of fluid into the veins of the sclera. About 5% of the substance can penetrate the ciliary body and end up in special collectors of the ocular choroid.
If inflow and outfloware in balance, the person is he althy and can see normally. In case of 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 begin due to compression, degenerative changes cover the nervous system. Ganglion cells are affected. The final stage is neuropathy, the atrophy of the nerve fibers responsible for a person's ability to see.
Everything is connected
From birth signs, symptoms of glaucoma of the eye can be explained by anomalies associated with intrauterine development, tumor processes, damage to the integrity of the visual organs. Acquired glaucoma is more often diagnosed in people whose close relatives already had patients with this pathology. The risk group includes diabetics, hypertensive patients, patients with osteochondrosis of the cervical vertebrae, atherosclerosis.
Often signs and symptoms of secondary glaucoma are detected in persons suffering from cataracts, occlusion, uveitis. The disease may appear on the background:
- hyperopia;
- atrophic processes of the iris;
- sclerite;
- keratitis;
- tumor process;
- injuries;
- burn;
- iridocyclitis;
- hemophthalmos.
Higher risk of glaucoma 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 isseveral parameters by which it is customary to divide pathology into categories. The simplest is primacy. The disease can develop on its own, affect the ophthalmic drainage, the ocular anterior chamber. The secondary form is a complication that develops against the background of various ophthalmic diseases (and other he alth 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. A symptom of type 2 glaucoma is a violation of the drainage of the eye, blocking the outflow of fluid. The first option - the corner of the chamber is open, however, the intraocular fluid cannot move normally (other factors play a role).
Pressure indicators allow us to divide all cases into three groups:
- normotensive;
- hypertension;
- high blood pressure.
In the first case, the tonometer shows about 25 mm Hg, hypertension is estimated at 26-32 mm. rt. st, the third type of disease is a persistent increase in pressure above 33 mm. rt. st.
Glaucoma can be stable - this is diagnosed if there is no negative dynamics when observing the patient for at least six months, and unstable, when the visual fields narrow, the optic nerve gradually degrades.
Stages of the disease
There are four stages in total. The easiest is the first, when the optic disk excavation has not yet extended to the edge, although the expansion is present.
The second stage is marked by correction of the parcentral visual field, some segmentsare narrowed by 10 or more degrees, and the excavation becomes marginal.
At the third stage, the field of vision narrows concentrically, excavation is marginal subtotal.
The fourth stage, terminal, is diagnosed if the patient has completely lost his sight or is only able to distinguish between the presence and absence of light. The excavation of the optic disc is absolute, the vascular bundle is displaced, the neuroretinal rim is destroyed.
Symptomatics
It is extremely rare to have noticeable symptoms of open-angle glaucoma. The field of view gradually decreases, but this process is very slow, takes years, and the person does not notice what is happening. At some point, the realization comes that in fact the world is perceived only through one eye - and only at this stage the patient turns to the doctor. True, there are cases when the development of glaucoma was accompanied by blurred vision, the appearance of iridescent circles before the eyes. Some have a headache, aching over the eyebrows. It happens that people pay attention to the deterioration of vision in the dark. A distinctive feature of the open-angle form is the defeat of two eyes at the same time. This is not always observed, but in the predominant percentage of cases.
Somewhat easier to notice the symptoms of glaucoma in the early stages, if the disease develops in angle-closure type. Before the disease itself, a stage of preglaucoma is isolated, after which the acute phase begins. It is followed by chronic. Preglaucoma does not show itself as symptoms, but it can be noticed whenpreventive examination by a doctor. The doctor finds that the corner of the anterior eye chamber is closed or significantly narrowed. Occasionally, the disease is accompanied by the appearance of iridescent circles in the field of view at the time of birth. There may be a feeling of discomfort in the eyes and even a short-term loss of the ability to see.
Closed angle: 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 eye 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 darkness can provoke an attack. It is known that sometimes the acute phase of glaucoma was observed with a long stay in a pose with a tilted head.
If the symptoms of glaucoma in adults at an early stage did not attract attention, acute 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 dark. The cornea dims, the pupil dilates, and its color changes to greenish. Seizures are characterized by hyperemia of the eyes. May be accompanied by bouts of nausea, heart and stomach pain. Some people feel dizzy, the pain responds in the area of the shoulder blades. To the touch, the eye becomes dense, as if stony.
Treatment for symptoms of angle-closure glaucoma possibleonly in hospital settings. The patient must be hospitalized and measures taken to reduce pressure in the organs of vision. You can use medications, but if this approach is ineffective, you will have to urgently undergo surgery. In the absence of adequate qualified assistance, the likelihood of irreversible blindness is high.
What's next?
The progress of the disease is associated with the transition to chronic pathology. At the same time, the pressure in the organs of vision gradually increases, relapses are observed from time to time - subacute attacks. The angle of the anterior eye chamber is gradually blocked more and more. Such symptoms of glaucoma in adults indicate that over time the optic nerve will atrophy, the person will become blind.
Diagnosis
To start timely treatment, the causes, symptoms of glaucoma should be the reason for going to the doctor. The earlier the disease can be detected, the better the prognosis. To do this, you need to regularly visit an ophthalmologist to check the pressure in the eye, examine the fundus, and the nerve disk responsible for visual function. The doctor evaluates the patient's field of view, studies how well the angle of the eye chamber works in front.
Don't wait for the symptoms of glaucoma to appear. Prevention of this disease, showing a really reliable result, is a regular examination by a doctor. To check the pressure indicators, elastotonometry, tonometry (one-time, during the day) are done. Electronic tonography is needed to identify the features of fluid transport in the organs of vision.
When suspectedfor glaucoma, perimetry is necessarily done, during which it is determined what the boundaries of vision are for the patient. Various methods are used to obtain the most accurate result. Most Popular:
- campimetry;
- isotopperimetry;
- computer measurement.
Precise perimetry helps to detect the symptoms of glaucoma at an early stage. The doctor may not be able to identify the causes of the disease in a particular case, but he will determine what measures need to be taken so as not to lose sight.
How to treat?
It was mentioned above that the best treatment for glaucoma symptoms is prevention. Unfortunately, it is not always possible to notice negative changes in the organs of vision in time. There are three main methods widely used to restore he alth in glaucoma:
- medicines;
- laser surgery;
- classic surgery.
The attending physician will help you choose the most suitable path for a particular case. Much depends on the form: treatment for symptoms of open-angle glaucoma is somewhat different than in the case of the second type.
When choosing medications, measures are taken to lower pressure indicators and stimulate blood flow to fully supply the nerve fibers with the necessary nutritional components. Normalization of metabolic processes in the organs of vision is an important step in improving the patient's condition. There are special drops against glaucoma. In pharmacies, they are represented by three groups of funds:
- stimulating fluid outflow (miotics,sympathomimetics, prostaglandins alpha-f-2);
- inhibiting fluid generation (alpha-, beta-blockers);
- combined formulations.
Cases vary
Symptoms, causes, prevention of glaucoma - you can be well versed in this topic, and yet one day you will encounter an angle-closure attack 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 reduce the pressure in the eye. The first medical 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 distractions. Particularly useful information about them is given to nurses, doctors as part of a course on the causes, symptoms, prevention, treatment of glaucoma. It is recommended to make mustard plasters, put banks. Hot foot baths, leeches on the chest will benefit the patient. To eliminate the situation of the corner block, to normalize the outflow of fluid, you will have to do an iridectomy using a laser unit. An alternative option is the classic surgical approach (basal iridectomy).
No surgery needed
As can be seen from the relevance for 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 patientrecommend undergoing laser surgery, and this requires a serious approach to choosing a reliable doctor. Modern patients have access to numerous methods and methods of eye surgery. There are lasers on:
- neodymium;
- argon;
- diodes.
In this case, the operation is carried out by the method of destruction or coagulation. The doctor, assessing the patient's condition, decides whether it is necessary to operate on the iris or trabeculae. Among the most popular approaches, it is worth noting iridectomy, iridotomy, iridoplasty, trabeculoplasty, goniopuncture. If the condition is assessed as very serious, cyclocoagulation using a high-precision laser is recommended.
Anti-glaucomatous surgery is widely practiced. The most commonly used invasive methods are:
- 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 expect?
Glaucoma is a chronic disease. At the moment, medicine does not have access to methods that can completely cure it. The main task of the patient is to control his condition, take a responsible attitude to lifestyle, and avoid factors that can provoke a relapse. The most positive prognosis is in patients who turn to the doctor in time and discover the pathology at an early stage. It is possible to achieve satisfactory therapeuticresults. Lack of treatment, uncontrolled progress - a guarantee of loss of vision.
To prevent the disease and notice it in time, you need to visit the doctor regularly to assess the fundus and visual fields. This is especially important for those who fall under the criteria of the risk group - persons among whose close relatives there were already patients with glaucoma, as well as all people over 40 years of age. More often, the disease is diagnosed in smokers, alcohol abusers, and people who are forced to work in specific conditions. In particular, glaucoma threatens those who work the night shift. If the visual, somatic background is assessed as severe, there are pathologies, you need to visit an ophthalmologist at least twice a year. If glaucoma is detected, you will have to register at the dispensary and undergo examinations at least four times a year. You will have to adhere to the treatment that the doctor will prescribe for life.
Useful and safe
To prevent glaucoma, it is necessary to use dietary supplements. They are also recommended if the disease has already been established. The choice of vitamins and minerals should be agreed with the doctor. The pharmaceutical industry produces a wide variety of products containing components that are beneficial to human vision. If the doctor prescribes medication, usually active ingredients are prescribed in addition to it to improve the nutrition of eye tissues. Formulas containing lutein are especially widespread. As an independent treatment, such drugs are not applicable, but significantly increase the effectiveness of the maincourse. With an increased risk of glaucoma, the use of nutritional supplements allows you to ensure a he althy present and future, and the preservation of vision for many years. Among the most popular products:
- Lutein Complex.
- "Blueberry Forte".
- Vitrum Vision.
Drops for glaucoma
Prostaglandin eye drops recommended for glaucoma patients are based on hormonal compounds. When prescribing a medicine, the doctor warns of possible side effects: the eyes may turn red, the iris may darken. Perhaps a change in the color of the eyelashes, tingling in the eyes. Sometimes objects appear blurry. Most popular lineups:
- Lumigan.
- Reskula.
Beta-blockers are just as effective, but can also cause side effects. Among other things - a decrease in pressure, a decrease in heart rate, chronic fatigue. Possible violation of sexual function. Popular means:
- Betoptik.
- Timoptik.
Carboanhydrase inhibitors are infrequently used drugs that help reduce the activity of cells responsible for the production of intraocular fluid. These can cause an increase in the urge to urinate, tingling of the extremities, a taste of metal in the mouth. Known funds - "Azopt" and "Trusopt".
