Glaucoma - what is it? Description of the disease, causes, symptoms, diagnosis and treatment
The diagnosis of "glaucoma" seems like a different sentence. Indeed, the disease is terrible, and its consequences are the most unpleasant, even blindness. The concept of the national team, currently glaucoma, combines about six dozen diseases, one of the symptoms of which is an increase in pressure inside the eye, gradually leading to atrophy of the nervous system of the organs of vision.
About how vision changes in glaucoma, they knew even in ancient times, and the term itself proves it - it first appeared in Ancient Greece. The disease was called the "shade of sea water" because an acute attack is accompanied by an expansion of the pupil and loss of mobility. The shade becomes greenish. Glaucoma some called green cataract.
There are many types of glaucoma, but with all of them, the patient's eyesight gradually becomes cloudy, his eyes hurt, and a feeling of cutting occurs in them. Vision becomes worse, and it is especially noticeable at a reduced level of illumination. If a person looks at the source of bright light, rainbow circles will appear before his eyes. The harder the case, the longer the disease progresses, the worse the patient sees. Gradually become less visual field. The process is long, proceeds inconspicuously for the person himself, and it is usually possible to identify him only during a routine examination in the office of an ophthalmologist.
Features of the diagnosis
Glaucoma is a disease in which the reddening of the sore eye is inherent; gradually the shade changes to bluish, faded. The pupil expands, ceases to respond to light during an attack. This period is accompanied by vomiting, nausea. With an attack of the eye becomes hard - this can be understood by feeling the area.
There are cases when glaucoma appears in babies. On average, the frequency of occurrence is one child out of 30,000. The elderly are much more likely to learn about glaucoma from their experience.What kind of illness this is, they know about one-tenth of a percent of all people 40-50-year-olds, and in the age group ten years older than the disease is diagnosed in one and a half percent. Among those over 75, glaucoma is, on average, detected in three out of a hundred. As shown by specific studies conducted on a global scale, among other causes of blindness in old age, glaucoma is one of the most frequent.
Anatomy and Medicine
Doctors have long been studying glaucoma. What it is, you can understand, if you first understand the features of the human eye. This body has a complex structure. Its main parts are a transparent cornea covering the outside of the organ, an opaque sclera that smoothly passes into the front cornea, a chamber filled with fluid that separates the iris from the cornea, the cornea itself having a pupil in the center. Its diameter is adjusted, determined by the intensity of the illumination of space. Also in the eye there is a lens (lens), the ciliary body, where the lens is attached by muscle fibers, the vitreous body - due to it the apple retains a stable shape. Photoreceptors are localized on the retina, and nutrition is implemented through the choroid.Signals generated by tissues in the brain are transmitted through the nervous system - the optic nerve.
In order for the eye to work well, a stable level of internal pressure of the fluid generated by the elements of the ciliary body and localized in the posterior ocular chamber is necessary. The liquid washes the lens and flows through the pupil and drainage into the veins of the sclera - this way passes about 95% of the generated substance. Residues may pass through the ciliary body, the sclera, and leak into the blood vessels of the choroid. In violation of the processes occurs glaucoma. The doctor will explain what the illness is: the so-called condition in which the outflow of fluid is disturbed, which leads to accumulation of the substance, increased internal pressure and increased load on the eye elements. Sooner or later it provokes a violation of blood flow and atrophy of the optic nerve. The brain can not receive signals, which means that a person gradually loses the ability to see.
Nuances and reasons
Glaucoma is formed in the elderly, infants and persons of other age groups for various reasons. Congenital abnormalities, a violation of the eye structure, genetic prerequisites and a lack of functioning of the immune system are possible. There are cases when glaucoma was provoked by other diseases.The risk of such a disorder is especially high in diabetics and those suffering from myopia, cataracts, and hyperopia. High likelihood of developing glaucoma on the background of astigmatism.
Doctors distinguish several types of the disease. So, babies are usually diagnosed congenital. This is due to anomalies of the structure of the eye. You can see already in the first months of life, if the child has glaucoma. What is it, where did the disease come from, parents tell doctors. It is usually associated with the violation of the mother during the carrying of diseases, as well as harmful habits. It is known that the probability is higher if the pregnant woman was under the influence of radiation, suffered thyrotoxicosis or mumps, rubella. Congenital glaucoma is popularly known as the bull's eye.
Forms and types: classification features
Sometimes at an early stage glaucoma is detected in adolescents. It is usually diagnosed with the juvenile form of the disease. People older than three years old are subject to it.
The most common type of disease is primary in adults. Its causes are age-related changes in organic tissues that form the visual system.
Secondary glaucoma, inherent in older people - eye disease, due to other diseases or impaired functionality of various tissues and organs, including visual.
Primary cases are divided into open-angle, closed-angle. The first ones are explained by the genetics of the patient, but the probability of their development is higher if the person is exposed to aggressive factors. These include age, diabetes, high blood pressure, atherosclerotic plaques, osteochondrosis, located in the cervical spine, myopia.
These factors lead to a decrease in the quality of blood flow, a violation of metabolism in the eye tissues. Usually, in this form, the damage of two eyes is observed simultaneously, but the processes are asymmetric. In many ways, the problems of diagnosis and treatment are the symptoms of glaucoma, since in this form the disease does not manifest itself for a long time. The pressure inside the eye gradually increases, but the patient cannot notice this.
The angle-closure is more commonly diagnosed in the elderly. The risk group - people who naturally have small eyes,large lenses and some other anatomical features. Higher probability of getting sick with age and with increased activity of producing fluid inside the eye. It is necessary to consider when choosing a treatment for the symptoms of glaucoma, due to a violation of the outflow of fluid. As a rule, a person notices the disease during an acute attack. It can be triggered by overwork, stress, prolonged stay in the dark or taking certain medications. After the attack, the angle is restored, the fluid is removed, the pressure stabilizes. Over time, spikes appear between the angular walls, the disease becomes chronic, the pressure inside the eye is constantly above the norm.
The development of angle-closure glaucoma is three stages. First there is preglaucoma without clinical symptoms, followed by an acute attack and a chronic form of the disease.
Many cases are known when, for glaucoma, the pressure inside the eye, although elevated relative to the mean, is within the normal range. The disease in this case is usually due to a violation of the functionality of the internal structures not due to pressure.Perhaps, for example, damage to nerve fibers, which is often observed against the background of increased pressure in the arteries, endocrinological failures, migraines, and heart diseases. The optic nerve may suffer due to the judgment of blood vessels.
With normal pressure inside the eye, glaucoma is possible with collagenosis, that is, a disease localized in the connective tissues. Because of this violation is limited to the flow of blood to the nerve structures. Collagenoses are not uncommon on the background of low blood pressure, atherosclerosis, and large blood loss.
How to help?
Emergency care is required if an acute attack occurs. In glaucoma, drugs are used to lower the pressure. Sometimes the only method is surgery. In the absence of adequate assistance, there is a risk of total blindness.
The simplest method of reducing pressure is a one percent solution of pilocarpine. The first two hours use the drug drop by drop every quarter of an hour, the next couple of hours, the frequency is halved, using drop by drop half an hour. For another two hours, pilocarpine is applied drop by drop per hour. Such treatment will show efficacy; under the influence of pilocarpine, the pupil becomes narrower.If the initial use of the drug did not show the effect, pilocarpine is not instilled. Drug treatment of glaucoma involves the use of diuretics. As a rule, prescribed "Furosemide" long course. Single dose - 20-40 mg.
What will help?
In the absence of a pronounced effect for intravenous injection, solutions of promedolum, promethazine are used. Dimedrol, aminazine for injective administration are used. After the injection of the mixture of drugs, the patient must lie in bed for at least four hours, otherwise the probability of orthostatic collapse is high.
To facilitate the condition, you can make a hot foot bath and mustard plasters. It is allowed to put leeches on whiskey. However, without drug therapy, such approaches will not show the effect - they can only be used as ancillary.
If during the day it was not possible to achieve a lasting improvement in the condition, an operation on the eyes is shown. Glaucoma is treated with iridectomy. This is an intervention during which the doctor creates a channel for the outflow of fluid from the eye space.
Only a highly specialized doctor, an ophthalmologist, can detect glaucoma. To clarify the condition of the patient is directed to instrumental studies.Twice a day you need to check the pressure inside the eye. Measurements are carried out in the morning before lifting and 12 hours after the first procedure. At the reception, the doctor will examine the fundus and the nerve disc. According to a special technique, they determine what the field of view is. Ophthalmography, tomography, polarimetry - methods widely used in modern practice. To clarify the condition of the patient, gonioscopy, ultrasound examination.
How to help the patient?
The doctor may recommend a medical course or operation. As a rule, prescribed eye drops. When glaucoma use "Pilocarpine", "Travatan." Such a drug method is considered the most effective, it allows you to control the pressure readings. On sale if two types of drops: stimulating the outflow of fluid and the depressing processes of its production. To improve the effectiveness of the course, the patient is shown to use vitamins and regularly undergo physical therapy.
In case of glaucoma, eye surgery is possible, if in this way it is possible to remove the obstacle preventing the liquid from leaving. Some experts believe that it is necessary to resort to a surgical approach, as soon as possible, while others prove that the best effects are possible if delayed with the procedure.
Surgical intervention is indicated if the pressure is steadily above the norm, drug therapy is ineffective in correcting it, and the visual fields gradually become narrower. If the symptoms of the disease worsen, eye drops in glaucoma do not give an improvement, it is necessary to seek help from a surgeon. Developed four methods of operations.
A penetrating surgical procedure is an event during which the doctor forms a new pathway for fluid flow.
Non-penetrating type - sclerectomy. It is used when open-angle form.
Two more types are interventions in which the circulation of the fluid and the production of this substance are normalized.
Currently, the most widely used laser devices for operating patients. At the same time, it is possible to restore the natural ways to drain the liquid. With such an operation, the likelihood of complications is minimal, the recovery period is short, and during work, local anesthesia is sufficient.
The main weaknesses of the laser are the increased pressure in the eye in the first few hours after the event, the risk of damage to the lens capsule, iris and corneal epithelium.The more significant the progress of the disease, the less effective the laser is as a method of treatment.
If the doctor has recommended an operation, but the patient refuses such a method of treatment, the consequence of glaucoma is blindness.
Glaucoma and everyday life
One of the dangers of glaucoma is its invisibility to the patient. The absence of symptoms does not yet indicate the health of the visual system. If a glaucoma attack has already occurred, if there is suspicion of such a disease, if a period of preglaucoma is detected, it is necessary to be extremely attentive to the health of the visual system. A doctor should be visited four times a year, even if there are no unpleasant symptoms. If something worries, you need to sign up with a doctor for the near future.
The doctor will give certain recommendations based on the specifics of the case. We'll have to strictly follow them. An important aspect of lifestyle is proper nutrition, avoiding bad habits and adequate physical activity in everyday life.
In case of glaucoma, hypothermia is contraindicated, since low temperatures lead to an increase in pressure in the eyes. In the summer, you need to use special glasses for glaucoma - they are sold in opticians and pharmacies.You can use training glasses. The doctor will give a prescription for a specific instance.
In everyday life, it is necessary to avoid such postures when blood can flow to the head. This imposes restrictions on sports, daily tasks (mopping), summer work. You should not drive a car, especially at dusk and at night.
In many ways, health depends on the diet. It is necessary to refuse strong coffee, tea, spicy dishes and rich broths on meat. Exclude offal, bakery, muffins, sweets from the diet. Limit the use of easily digestible carbohydrates, fatty foods. The prohibition imposed on alcohol. Liquid per day is consumed in the amount of one and a half liters and less. Useful with eye diseases are considered low-fat varieties of meat, fish, dairy products, cereals. Patients are shown in large quantities fruits and vegetables.
How to warn?
The specific prevention of glaucoma is not currently invented. For persons over the age of forty, it is recommended to regularly visit the doctor to assess the health of the eyes. If there are glaucoma sufferers among relatives, all family members should be examined regularly.
Disease and its nuances
The study of ancient works showed that glaucoma was known as early as 400 before the beginning of our era. The disease described in his writings Hippocrates. A new surge of interest in the disease was observed in the Middle Ages - it was then that ideas began to take shape that underpin the modern understanding of the pathological condition. And today, doctors do not have a common opinion regarding the reasons for which glaucoma begins. Only one thing is known: completely different health problems sooner or later lead to nervous atrophy and loss of the ability to see. WHO experts estimate that about five million people are now completely blind due to glaucoma.
You can notice glaucoma in your eyes if your vision is blurred, you feel heavy in your eyes, it hurts, it cuts and burns. The visual field gradually narrows, but this symptom is rarely seen. The reason for contacting the doctor should be the deterioration of the ability to see in the twilight, the darkness.
As an additional method of treatment of the disease resorted to physiotherapy. Such activities are aimed at stimulating metabolism at the cellular level, activating the outflow of fluid from the eye.Gradually, pressure levels off, vision stabilizes. At home you can use glasses Sidorenko. This is a device for a complex effect on the visual system. Simultaneously, the effect occurs on the eye and on the tissue nearby. Multi-factorial effect - ultrasound, massage, color, phonophoresis. The device is effective in glaucoma, cataracts, and other visual impairment.
Do not expect that physiotherapy will replace medical or surgical treatment. Special devices - this is only an additional way to improve the patient, but as the main method of eliminating the pathology is ineffective.