Chronic open angle glaucoma

Description:

Chronic open angle glaucoma - the chronic disease which is characterized by increase in the intraocular pressure (VGD) that leads to excavation and an atrophy of an optic nerve and the progressing narrowing of fields of vision. An open angle glaucoma mean lack of closing of a corner of an anterior chamber of an eye by the term; increase in VGD is caused by disturbance of outflow of watery moisture owing to changes in drainage system and/or the shlemmovy channel. Adequate decrease in VGD most often leads to process stabilization.

Frequency. 0,1% of patients at the age of 40-49 years, 2,8% - at the age of 60-69 years, 14,3% - are aged more senior than 80 years. The prevailing age - is more senior than 40 years (though the beginning is possible at any age). The prevailing floor - men's.

Symptoms of the Chronic open angle glaucoma:

The clinical picture often is absent up to development of irreversible changes of an optic disk. The gradual progressing deterioration in sight up to development of a total blindness. Moderate headaches, emergence of iridescent rings at a view of a source of bright light.

Reasons of the Chronic open angle glaucoma:

Genetic aspects:
There is a set of the hereditary glaucomas and diseases accompanied with glaucoma. Risk factors: a diabetes mellitus or the lowered tolerance to glucose, a myopia.

Treatment of the Chronic open angle glaucoma:

Treatment should be directed on decrease in VGD for the purpose of prevention of further progressing of decrease in visual functions. Decrease in VGD reach by an instillation in an eye of the HP improving outflow of watery moisture or lowering its products (oral administration of drugs is possible). Observation - each 2-3 months, at inefficiency of medicinal therapy the laser trabekuloplastika is shown. At inefficiency of a laser trabekuloplastika the sinusotrabekuloektomiya is shown.
Medicinal therapy - usually begin with local administration of one drug, gradually adding others before decrease in VGD.
Drugs of local action. The drugs reducing secretion of watery moisture:
V-adrenoblockers (for example, Timololum, бетаксолол, проксодолол). Adrenomimetiki (Epinephrinum; дипивефрин - pro-medicine from which at biotransformation in tissues of an eye adrenaline is released; апраклонидин). Karboangidraza inhibitors (дорзоламид).
The drugs increasing outflow of watery moisture: M-cholinomimetic (Pilocarpinum) or (at their inefficiency), M - and N-cholinomimetic means (Carbacholinum).
Cholinesterase inhibitors (for example, physostigmine, echo thioveils iodide).
Drugs of resorptive action - for decrease in secretion of watery moisture. Acetazoleamide (Diacarbum) of 125-250 mg 2 or 4 р / days Dikhlorfenamid Metazolamid. Contraindications: Non-selective V-adrenoblockers in eye drops can have resorptive effect; they are not recommended to appoint at bronchial asthma and chronic obstructive diseases of lungs. Inhibitors of a karboangidraza of resorptive action are contraindicated at OPN, a hypopotassemia, acidosis, a diabetes mellitus, pregnancy (the I trimester). Precautionary measures: It is necessary to appoint Adrenomimetichesky drugs with care at associated diseases of CCC. V-adrenoblockers should be applied with care at heart failure, bradycardia, at simultaneous treatment by blockers of calcium channels. At treatment by inhibitors of a karboangidraza systematic determination of quantity of erythrocytes, leukocytes, the maintenance of Hb, Ht, and also content of potassium in blood serum is recommended. At use of strong mystical means, for example an ekhotiofata, the cataract or amotio of a retina can develop.