Glaucoma is one of the most severe eye diseases, characterized by rapid progression and leading to irreversible blindness. Glaucoma includes not one, but a group of different lesions of the visual organ, in which there is a constant or periodic increase in intraocular pressure( IOP), a decrease in visual acuity and nerve atrophy (optical neuropathy).
The pathological process begins with the deterioration of the lateral (peripheral) vision. With a further increase in IOP and no treatment, the optic nerve dies off, which leads to a sharp decrease or complete loss of vision.
Quite often, the diagnosis of glaucoma is carried out already with a significant deterioration of vision or after its loss. This is due to the fact that, as a rule, the disease does not manifest itself in the early stages.
Sometimes with glaucoma, acute pain in the eye occurs, but such signs do not belong to the specific symptoms of glaucoma and can occur with other ophthalmological diseases.
The main causes of the disease
Intraocular pressure is the main aspect of assessing the health of patients who are at risk of glaucoma. Normally, the pressure in the eye is 18-24 mm Hg due to the balance of the formation of intraocular fluid and its outflow. In glaucoma, this process is disrupted, as a result, the resulting fluid accumulates, resulting in increased IOP.
High blood pressure negatively affects the optic nerve, its blood supply deteriorates, and after a while the nerve dies.
Initially, the pathological changes are reflected in the lateral vision, which begins to decline sharply. Over time, visual acuity deteriorates and irreversible blindness develops.
Only early diagnosis of the disease allows for effective treatment and prevents the development of blindness.
Risk factors for glaucoma
More often, glaucoma is diagnosed in the presence of the following adverse factors:
older age (after 70);
periodically increasing IOP;
low blood pressure;
hormonal and nervous system dysfunctions;
diseases of the cardiovascular system;
surgical intervention and past inflammatory processes;
the presence of glaucoma in relatives;
long-term use of hormonal drugs.
According to the WHO, glaucoma is the leading pathology of the visual apparatus, leading to loss of visual function. More than 14% of people worldwide who suffer from blindness have lost their sight due to glaucoma.
Clinical signs of glaucoma
Damage to the visual organ can manifest itself in one or more symptoms. It is important to contact an ophthalmologist in time for an examination and a comprehensive diagnosis.
Signs of glaucoma:
periodically there is a feeling of pain, soreness and heaviness in the area of the affected eye;
reducing the field of view;
fog before my eyes;
colored spots and circles when looking at a bright light source;
reduced vision at dusk (in the evening and at night);
intermittent mild soreness;
hyperemia of the eyeball.
Forms of the disease
There are two main forms of glaucoma that have their own characteristics:
Open-angle-occurs in 90% of cases and is characterized by an open (wide) iridocorneal angle, but with a disorder of its functioning, an increase in pressure may occur. With an open-angle form, symptomatic signs do not appear in any way, so the decrease in the radius of the field of view occurs imperceptibly, it can last up to two or three years. Less often, patients complain of a hazy haze in front of their eyes or colored spots that occur when looking at a bright light source. A person may accidentally discover that one eye sees only partially. Sometimes there are signs of fatigue with intense visual work.
Closed-angle-it is rare, mainly in people suffering from farsightedness after 35 years. There is a sharp increase in IOP, which leads to the development of characteristic symptoms: acute pain in the affected eye, migraine, hyperemia of the eyeball, swelling, decreased vision, up to its complete loss, the pupil dilates and does not respond to light. Sometimes there is an optical phenomenon – when looking at the light source, the patient sees a halo around it (a glowing ring).
forms of glaucoma
The closed-angle form, as a rule, proceeds acutely. Acute attacks can cause a sharp loss of vision.
For early detection of pathological processes, IOP is measured, the fundus and optic disc are examined with special devices, and the visual field is examined to detect defects in central and peripheral vision.
For the diagnosis of glaucoma, a comprehensive examination is prescribed, including refractometry, automated perimetry, tonometry, ultrasound, assessment of the depth of the anterior chamber, determination of the thickness and diameter of the lens, gonioscopy (study of the angle between the cornea and the iris), determination of the thickness of the cornea.
It is not possible to completely get rid of glaucoma today, but with correct and timely treatment, it is possible to slow the progression of the disease. The choice of therapy method directly depends on the severity of the pathological changes, the symptoms present, the form of glaucoma and consists in the use of medications, surgery or laser therapy.
The main objective of the treatment is to reduce intraocular pressure, normalize blood supply to the optic nerve, and improve metabolic processes in the tissue structures of the eyeball.
Conservative (medical) treatment includes the use of eye drops with different effects:
- means for improving the outflow of fluid inside the eye;
- medications that inhibit the production of intraocular fluid;
- combined drugs.
In acute closed-angle form, emergency measures are taken to reduce intraocular pressure. In the future, to normalize the outflow of fluid, a corrective iridectomy (partial removal of the iris) is performed.
Complete a complete visual examination
Prognosis and prevention
It is very important to start treating the disease at an early stage, when the pathological changes occurring in the structures of the visual apparatus can be corrected and achieve the most positive results.
With the spontaneous course of glaucoma, the lack of adequate therapy, the prognosis of the disease is unfavorable, and soon this leads to partial or complete blindness.
Prevention of glaucoma is an early diagnosis, for this it is necessary to regularly visit an ophthalmologist for people over the age of 40, as well as those who are at risk. If glaucoma is present, the patient is examined by an ophthalmologist every 6 months and receives recommendations for treatment.