What is open-angle glaucoma and how to treat it?
Mar 06, 2018
Glaucoma is a constant and temporary increase in intraocular pressure, which causes atrophy of the optic nerve and blindness. There are different types of glaucoma, but the most common of these is open-angle glaucoma, which accounts for about 80% of all clinical cases and occurs mostly in people older than 40 years.
Causes of open-angle glaucoma
According to the specialists' research, glaucoma refers to multifactorial diseases, that is, it requires a combination of many causes and provoking factors. To make the pressure in the eye exceed the norm, serious causes are needed that make it difficult to drain the aqueous fluid( watery moisture).
Liquid, which is produced by the ciliary body, constantly circulates in the eye from the posterior chamber to the lens, and then into the anterior chamber. The outflow of fluid occurs at the level of the angle in the anterior chamber through the helmet channel( depression) directly into the venous system of the eye.
In form, the open-angle form of glaucoma is primary and secondary. Primary open-angle glaucoma occurs if blockade and obstruction of outflow are at the level of the helmet canal. The cause of primary glaucoma are various anomalies of the anterior chamber and its angle. This may be anomalies of attachment of the ciliary muscle, scleral spur and other parts of the eye, through which the outflow of fluid occurs.
In addition, the provoking factors that cause the primary and secondary forms of glaucoma are:
- Heredity( the presence of glaucoma in the genus).
- Diseases of the cardiovascular system.
- Diseases of the nervous system.
- Endocrine disorders.
- A sedentary lifestyle.
- Having bad habits.
Symptoms of the disease
The most dangerous is the fact that this form of glaucoma begins and flows imperceptibly for the patient. Literally until the last, patients may not notice that their field of vision is progressively narrowing, which starts from the peripheral field, and then passes over to the entire field of view. Bright and pronounced symptoms of open-angle glaucoma are observed only in 15-20% of all patients.
- Headaches and pain in the eyes.
- The appearance of the halo around the bright light.
- Reduced vision and blurred vision, especially in the evenings.
- Syndrome of "tunnel vision", when patients see objects as in a narrow tunnel.
When measuring intraocular pressure, the figures are usually greater than 21 mm Hg.st., but in the last stages of the disease can be within 35 mm Hg. Art. When examining the optic nerve, his dystrophy is noted, and in the last stages of the disease - atrophy.
Early diagnosis of open-angle glaucoma usually presents difficulties, as patients do not experience any sensations, except for the decrease in vision that they write off for age. That is why all people after 40 years are shown preventive examinations from an ophthalmologist with measurement of intraocular pressure at least once a year. People with existing diseases of the endocrine, cardiovascular and nervous systems are shown to see the doctor at least once every 6 months.
Treatment and therapy
The open-angle form of glaucoma can be controlled, but it can not be cured completely, therefore, treatment should be carried out continuously, from the moment it is detected in the patient. When glaucoma is detected before the appointment and choice of therapy, the patient is examined in inpatient or outpatient settings.
Treatment of open-angle glaucoma can be conservative or operative, depending on the stage and severity of the disease. The goal of any therapy is to control and reduce intraocular pressure.
In the initial stages of the disease, conservative therapy is successfully used, which includes eye drops for topical application. The principles used in conservative therapy are as follows:
- Reduces the amount of watery moisture( pilocarpine, betaxolol, timolol).
- Improved drainage from the front chamber.
- Effects on the causes that led to the formation of glaucoma( clonidine as an antihypertensive agent).
- Maintenance of balance of inflow and outflow of a moisture( arutimol, окупресс, тимоптик, опмол).
- Hypotensive and decongestant therapy( diacarb against the background of panangin or potassium orotate).
In addition, in conservative therapy, physiotherapeutic methods of treatment( for example, electric stimulation of the optic nerve disk) and intraocular injections with a mixture consisting of vitamins and minerals can be used. If such therapy gives good results and normalizes the pressure, the patient is simply examined periodically( 1 every 6 months), regularly and strictly by the hour using eye drops.
Treatment of open-angle glaucoma by surgery is performed in cases where conservative therapy methods do not have the expected effect. This form is easier to treat, in comparison with the closed-angle glaucoma, including the operative one.
The operations are performed using a laser and using conventional eye microsurgery. Laser treatment refers to innovative methods of therapy and is successfully used in the initial stages of the disease, as long as there is no optic nerve atrophy.
Operation with open-angle glaucoma is performed to improve the outflow of intraocular fluid by creating new ways of outflowing aqueous humor. Some forms of operations are used to open old ways of outflow of moisture. Most often used such operations as laser trabeculoplasty, laser ciliolyablation or filtering operation.
It should be remembered that the operation does not save from the development of dystrophic processes, especially if the patient has an old age and a mass of concomitant diseases. Therefore, in some cases, you may need to repeat the operation. In any case, it is necessary to adhere to the following rules:
- After 40 years, undergo an examination with an ophthalmologist once a year and measure intraocular pressure.
- In the case of existing hereditary heredity and other eye diseases( myopia, cataract and others), regardless of age, undergo a preventive examination.
- If you experience visual impairment and other symptoms of glaucoma, seek immediate help and undergo a complete examination.