Types of glaucoma, symptoms, causes and treatment
Glaucoma is a disease that affects the organs of vision. The main reason for its occurrence is an increase in intraocular pressure against which the circulation of intraocular fluid is disturbed. The optic nerves undergo necrosis, which leads to visual impairment, up to complete blindness. Therefore, glaucoma requires treatment that must be started immediately.
It is important to know the symptoms of glaucoma in order not to miss the onset of the development of the disease. A timely visit to a doctor will allow you to choose the right treatment and prevent the development of severe complications.
- Types of glaucoma and their symptoms
- Risks of developing glaucoma
- The first symptoms of glaucoma development
- When should you see a doctor?
- Glaucoma treatment
- Glaucoma surgery
Types of glaucoma and their symptoms
Open angle glaucoma
Open - angle glaucoma is the most common disease in comparison with other forms of glaucoma. The front of the eye with this shape looks standard, but a lot of fluid accumulates in the eye itself, and due to which there is an increase in eye pressure. This is due to the fact that the liquid does not find the desired outflow. As a rule, the attending specialist prescribes medicine in order to lower the intraocular pressure, but this does not always help. In this regard, it is necessary to perform the operation using a laser or other surgical devices.
Symptoms of open-angle glaucoma can be difficult to identify. This is especially true for the early stages of the development of the disease. It is capable of progressing for a long time, but at the same time it will not give any obvious manifestations. Intraocular pressure does not increase much, so the person does not notice these rises. At the same time, the structures of the eye do not stop suffering. Obvious symptoms of the disease may appear at the last stage of glaucoma development, when it will no longer be possible to prevent vision loss. Only during this period a person turns to a doctor.
The first signal of vision problems is the appearance of bright circles around objects. Such a border will shimmer with all the colors of the rainbow. You should also pay attention to headaches and eye pains. Glaucoma often causes blurred vision and blurred objects.
You can make various assumptions on your own and lose precious time. The correct diagnosis can only be made by an ophthalmologist who will examine the patient using special devices. Even if a person correctly diagnosed himself, this does not mean that he can begin treatment. It is forbidden to take drugs for glaucoma without medical supervision. Do not use drugs that reduce intraocular pressure. This can cause serious complications.
The older the person is, the more likely they are to develop glaucoma. Therefore, as a preventive measure, people over 40 are recommended to visit an ophthalmologist once a year. This should be done even if no symptoms of the disease are observed.
Angle-closure glaucoma is glaucoma that occurs when some of the front parts of the eyeball are damaged, and this leads to severe pain in these places. In this case, there is also a narrowing of the space between the iris and the cornea of the eyeball, and the fluid inside the eye does not find an outflow. If outflow is not possible, there is very strong intraocular pressure. With angle-closure glaucoma, the patient experiences severe eye pain, while with open-angle glaucoma, the patient does not experience any pain. With this form of the disease, headaches, nausea, vomiting, iridescent circles in front of the eye, and redness occur. An acute attack of glaucoma is an urgent condition that requires immediate initiation of adequate treatment. If treatment is not started, a person can lose their sight in a few hours.
The difficulties the patient faces:
- A person should not bend his head down. The more often he does this, the higher the likelihood of developing severe complications.
- A ban is imposed on work in those rooms where the air temperature is always at high marks.
- In the dark, at dusk and in insufficient light, the patient should not strain his eyes.
- A person must strictly control the amount of liquid that he consumes during the day.
- Any medications that can provoke pupil dilation or increased intraocular pressure are prohibited.
Symptoms that indicate angle-closure glaucoma:
- Deterioration of vision, blurred objects.
- Pain that focuses on the eyebrows and eyes. It occurs at regular intervals.
- The appearance of a bright rainbow rim around any light source and even around normal objects.
- Change from acute periods of illness to periods of calm. The absence of symptoms is not a sign that glaucoma has stopped progressing. Vision continues to fall.
- Narrowing and closing of the angle of the anterior chamber of the eye. With a significant increase in intraocular pressure, the patient's protein turns red, the cornea swells. This symptom can be noticed even by an ordinary person with no medical education.
In patients with this form of the disease, not only the outflow of intraocular fluid is difficult, but also the angle of the anterior chamber is blocked.
Secondary glaucoma is glaucoma that occurs due to causes such as inflammation, trauma, surgery, diabetes, tumors, and certain medications.
Congenital glaucoma is a consequence of intrauterine malformations, usually found in children. It is treated with surgery.
Risks of developing glaucoma
The likelihood of developing glaucoma increases in the following categories of people:
- People who smoke, people with alcoholism. These bad habits lead to a regular increase in intracranial pressure.
- People who eat poorly.
People who take drugs thoughtlessly and without medical supervision. It is important to warn your doctor about your illness. Sometimes the usual understatement becomes the cause of blindness. So, a team of doctors who came to a call about an attack of hypertension or bronchial asthma are injecting the patient with Euphyllin. It contributes to the exacerbation of glaucoma and the person loses sight. Therefore, every doctor who prescribes treatment should be informed about their disease.
The first symptoms of glaucoma development
It is necessary to dwell in detail on the symptoms of glaucoma, which appear very first. These include:
Rainbow circles. It is the iridescent circles that are the sign that most often indicates developing glaucoma. They arise when a person directs his gaze to the source of light. The object itself will be dark, but surrounded by a rainbow halo. Closer to the light source, the color is purple, and further away from it, it is red. All shades of the rainbow are observed in the center.
Ophthalmologists indicate that this symptom occurs in 75% of people with glaucoma. Moreover, he appears early, when the other signs of the disease are still absent. The cause of iridescent circles is an increase in intraocular pressure, which happens due to swelling of the cornea.
Rainbow circles are ways to signal other visual impairments. They occur in people with conjunctivitis and with pathological changes in the lens.
Comparative characteristics of rainbow circles in different ophthalmic diseases:
- Conjunctivitis. A rainbow rim around an object occurs when a person looks at a light source. After excess mucus is removed from the eye, the bright halo dissipates.
- Cataract. Circles appear frequently. Their provoking factor is the ingress of certain contaminants into the eye.
Glaucoma. With this pathology, circles do not disappear if dirt or mucus is removed from the eye. They always occur when a person looks at a light source.
After reading the information and finding rainbow circles in front of his eyes, a person should not start to panic. This symptom is the reason for contacting an ophthalmologist and undergoing examination.
Blurred vision. Occasionally, people with glaucoma have fog in front of their eyes. This leads to the fact that it will be difficult for a person to examine in detail the objects that surround him. He has the impression that they are covered with a slight haze. Sometimes the blurred vision is so intense that the patient cannot even clearly define the boundaries of objects and their color. The reason for the appearance of such a fog is an increase in intraocular pressure, against the background of which corneal edema occurs. This symptom can persist for a long time: from several minutes to several hours.
Headaches and eye pains. Headache often accompanies developing glaucoma, but a person rarely correlates these two phenomena with each other. This is especially true in the case when the disease affects two eyes at once. It is easier to suspect glaucoma from a headache in the case when the pathology develops in only one eye. Painful sensations are concentrated in the temporal region on the side where glaucoma manifested. The pain pulsates, proceeds as a spasm.
Lachrymation. Normally, tears from the eyes do not flow on a consistent basis. However, with glaucoma, there is a failure in the outflow and inflow of intraocular fluid, as well as an increase in pressure inside the eye. Therefore, the production of tear fluid is increased. This symptom requires a visit to a doctor.
False hydration of the eye. A person with glaucoma may feel like their eyes are filling with tears. If he tries to get them wet, he will find that there are actually no tears. This feeling arises due to the fact that the patient has increased intraocular pressure.
If a person discovers one or several symptoms at once, indicating the early development of glaucoma, he needs to consult a doctor.
When should you see a doctor?
There are three signs that can indicate developing glaucoma, but, at the same time, they characterize many other diseases. In any case, their appearance requires an appointment with an ophthalmologist.
These are symptoms such as:
- The appearance of flies before the eyes.
- Rapid fatigue of the organs of vision.
- Fatigue of the optic nerve after a short exercise.
When they appear, you must immediately undergo an examination.
Glaucoma leads to irreversible consequences. Therefore, the earlier a person gets an appointment with an ophthalmologist, the faster it will be possible to stop the progression of the disease and the less harm it will cause to vision.
The main task of therapy is to reduce intraocular pressure. Sometimes it can be solved by using eye drops, and sometimes you have to resort to the help of a surgeon.
Eye drops for glaucoma treatment
It is possible to relieve intraocular pressure with eye drops. Their action is based on the fact that the outflow of fluid from the eyes is normalized.
Drugs that can be used to treat glaucoma:
Drops containing prostaglandins. They help to reduce intraocular pressure. After installation, patients often experience redness of the mucous membrane of the eye, a tingling sensation, darkening of the iris, and blurred vision. Sometimes there is a change in the color of the eyelashes. These medicines include drops of Reskula, Travatan, Lumigan, Xalatan.
Beta blockers. These drugs interfere with the process of fluid production in the eyes. However, they have some side effects, including: hypotension, slowing heart rate, decreased potency, increased fatigue. These eye drops include: Betoptic C, Timoptic XE, etc.
Carbonic anhydrase inhibitors. These drugs are not often prescribed for glaucoma. They help to reduce the production of intraocular fluid, but can lead to a metal taste in the mouth, increased urination, and tingling in the fingers. Representatives of this group: Azopt, Trusopt, etc.
Alpha-adrenergic receptor agonists. These drops are aimed at reducing the production of eye fluid and improving its outflow. The use of drugs is associated with the risk of developing hypertension, arrhythmias. They sometimes cause dry mouth. These are such medicines as: Lopidin, Alphagan, Alphagan-P.
Sometimes local therapy is not enough. In this case, the doctor can prescribe drugs for systemic administration to the patient. For glaucoma, carbonic anhydrase inhibitors are used: Daranid, Diamox, Neptazan. However, about half of patients refuse such therapy, since the side effects of these drugs are very intense.
The operation is prescribed for all patients with primary open-angle glaucoma. It will not be possible to cope with the pathology with drugs. The patient will undergo a surgical procedure using local anesthesia. The method of linear trabeculoplasty is often used. To perform surgical manipulations, a goniolinse is used.
Deep and non-penetrating sclerectomy can also be done to treat open-angle glaucoma. The procedure is aimed at reducing intraocular pressure by thinning the area of the peripheral cornea. This allows the intraocular fluid to seep better through its membrane. To prevent the formation of scar tissue on the eye, collagen drainage may be installed.
Surgery to get rid of glaucoma is actually not as dangerous as it might seem. Its duration is about 20 minutes. The person is not left in the hospital. After completing the procedure, he is under the supervision of a doctor for several hours, after which he is sent home. Next time he should visit the doctor in a few days. At home, you will need to use special eye drops. The doctor will write them out.
Types of surgical care
Patients with an acute attack of glaucoma are hospitalized. Treatment can be reduced to medical correction, although sometimes it is impossible to do without the help of a surgeon. Each attack of the disease is accompanied by a significant increase in the level of intraocular pressure. This threatens complete blindness. It will not be possible to restore vision in the future. If help is provided on time, then the function of the eyeball can return to normal. However, it is also impossible to exclude the likelihood of complications after the operation. There is always a risk, but without such treatment, the likelihood of loss of vision is much higher.
The operations performed for glaucoma can be of the following types:
Non -penetrating sclerectomy (non-distilling). This method is used to treat the open-angle form of glaucoma. The result of the operation is a decrease in intraocular pressure by thinning a limited area of the peripheral cornea. In some cases, collagen drains are installed to minimize tissue scarring.
This method of treatment is not as scary as it might seem. The operation lasts only 20 minutes, and then he can go home in a couple of hours. After the operation, eye drops prescribed by the doctor are used at home.
Trabeculectomy. This is a penetrating intervention.
Cyclocoagulation. The operation is aimed at reducing the production of intraocular fluid.
Iridectomy or iridocycloretraction. Both operations are aimed at normalizing the process of fluid circulation inside the eye.
iStent. This is a minimally invasive innovative technique for treating glaucoma. The procedure is carried out on a special device. Treatment allows to normalize the outflow of fluid from the eye and it is safe for the patient to reduce intraocular pressure.
Let us dwell on this method in more detail. iStent refers to a microinvasive surgical intervention, has some advantages over other types of surgical intervention.
- Short recovery period.
- Low likelihood of complications.
- Stopping the progression of the disease in the early stages of its development.
- The patient will not be bedridden.
- No medication is required after surgery.
There are also certain advantages to the iStent procedure.
- Safety of the procedure.
- During the operation, the tissues of the eyes are not cut, but pushed apart.
- The technique can be practiced in conjunction with other treatments.
The iStent unit itself is represented by a small device (it is the smallest of all devices that have ever been used in medicine). The doctor places it in the patient's eye. At the same time, the patient himself does not see and does not even feel it.
The device makes a hole in the trabecular meshwork. Through it, excess fluid will come out of the eye. The iStent is inserted through an incision that does not exceed 15 mm. The technique can be used to treat open-angle glaucoma of any severity. The age of the patient does not matter.
Sometimes another operation is required to completely get rid of glaucoma. Fistulizing techniques are rarely used. Penetration into the ocular cavity may be required for patients with progressive glaucoma, as well as for those people for whom gentle treatment methods have not brought the desired result.
Recovery after surgery
If the disease was detected in the early stages, then the operation can be performed using a laser beam. Most specialists give preference to this particular method of treatment. The procedure allows you to reduce intraocular pressure, improve the outflow of intraocular fluid and not prevent the development of complications of the disease.
Before admitting the patient to the operation, the doctor conducts a comprehensive examination. This will allow you to choose the best therapy method.
Glaucoma is chronic. Various modern methods of therapy can slow down the progression of the disease, but it will not be possible to completely get rid of it. This is important to understand and accept. No doctor can guarantee that a relapse will not occur after the intervention.
To reduce the likelihood of recurrence of the disease, you must strictly follow all the recommendations of a specialist. You should regularly visit the ophthalmologist and use the drugs that he prescribes.
In summer and spring, when the sun is more active, you must use special anti-glaucoma glasses.
- It is forbidden to overstrain your eyesight. You should not watch TV or work at the computer for too long. Lighting should always be of high quality.
- Diseases that are capable of provoking complications from the side of vision must be treated in time.
After surgery for the treatment of glaucoma, the patient may have severe watery eyes, sometimes irritation of the organ of vision is observed. Blurred vision may persist for several weeks. It takes about 2 months. Over time, eye function will stabilize. To recover faster, it is necessary to use Pilocarpine. This drug normalizes pupil size. The doctor may also advise the patient to wear lenses or glasses. It is important to observe hygienic measures aimed at preventing infection of the organ of vision.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".