Glaucoma

Description:

Glaucoma (from Greek - color of sea water, azure) – the serious illness of an organ of sight which received the name from greenish coloring which is got by a mydriatic and fixed pupil in a stage of the highest development of disease process – a bad attack of glaucoma. From there is also the second name of this disease – "green water" or "a green cataract" (from it. "Grun Star").

Now there are no uniform ideas of origins and mechanisms of development of this disease, certain difficulties even in the attempt to define the concept "glaucoma" meet.

Today glaucoma it is accepted to call the chronic disease of eyes which is characterized by continuous or periodic increase in the intraocular pressure (VGD) with development of trophic frustration in outflow tracts of intraocular liquid (VGZh, watery moisture), in a retina and in an optic nerve, the typical defects causing emergence under review and development of regional excavation (deepening, breakdown) of an optic disk.

Thus, the term "glaucoma" combines big group of the diseases of an eye (about 60) having the following general features:

  1. Intraocular pressure (VGD) constantly or periodically exceeds individually transferable (tolerant) level;
  2. Characteristic defeat of fibers of an optic nerve – the glaukomny optical neuropathy bringing in the final stage to its atrophy develops;
  3. There are disturbances of visual functions, characteristic of glaucoma.

Glaucoma can arise at any age, since birth, but prevalence of a disease considerably increases in elderly, and at senile age. So, the frequency of inborn glaucoma makes 1 case on 10-20 thousand newborns, at the age of 40-45 years primary glaucoma is observed approximately at 0.1% of the population. In an age group of 50-60 years glaucoma meets already in 1.5% of cases, and at persons 75 years more than at 3% are more senior. This disease is high on the list among the reasons of an incurable blindness and has the extreme social importance.

Glaucoma symptoms:

Distinguish inborn glaucoma, juvenile glaucoma (juvenile glaucoma, or glaucoma of young age), primary glaucoma of adults and secondary glaucoma.
Inborn glaucoma can be genetically determined (is predetermined) or caused by diseases and injuries of a fruit in the period of embryonic development or in the course of childbirth. This type of glaucoma is shown in the first weeks and months of life, and sometimes in several years after the birth. This quite rare disease (1 case on 10-20 thousand newborns).
Inborn glaucoma develops owing to the anomalies of development (generally in a corner of an anterior chamber) which are quite often resulting from various morbid conditions of mother (especially, till VII month of pregnancy). Lead infectious diseases to development of inborn glaucoma (a rubella, parotitis (mumps), poliomyelitis, typhus, syphilis, etc.), avitaminosis And, a thyrotoxicosis, mechanical injuries during pregnancy, poisonings, alcoholization, influence of the ionizing radiation, etc.
In 60% of cases inborn glaucoma is diagnosed for newborns. This state in medical literature sometimes call the terms "hydrophthalmia" (hydrophthalmos) or "буфтальм" (ox-eye). Cardinal symptoms of inborn glaucoma are the high intraocular pressure (VGD), bilateral increase in a cornea, and sometimes and all eyeglobe.
Inborn glaucoma
Inborn glaucoma. Pay attention to the big diameter of a cornea. On the left eye the cornea is edematous owing to the increased intraocular pressure (~ 35 mm hg.
Juvenile (juvenile) glaucoma arises at children is more senior than three years. Age limit for this type of glaucoma – 35 years.
Primary glaucoma of adults – the most often met type of glaucoma connected with age changes in an eye.
Secondary glaucoma is an effect of other eye or general diseases which are followed by defeat of those eye structures which participate in circulation of intraocular moisture or its outflow from an eye.

Glaucoma reasons:

Glaucoma is the disease arising owing to disturbance of hydrodynamics of an eye (the movement of intraocular liquid). At glaucoma there is a periodic or continuous increase in intraocular pressure. Under the influence of the increased intraocular pressure fields of vision are narrowed, the central sight decreases, there is an atrophy of an optic nerve. The total blindness happens an outcome of a disease. It is considered that every fifth blind patient lost sight because of glaucoma.

Treatment of Glaucoma:

The problem of any technique of treatment of glaucoma consists in normalization of intraocular pressure. Today there are three directions of treatment of this disease: medicamentous, laser and surgical.
After carrying out careful diagnostic inspection and detection of glaucoma for each patient make the individual scheme of treatment. It depends on a form, a stage of a disease and existence of the accompanying pathology. At early stages of glaucoma conservative treatment (eye drops) can be used. Unfortunately, medicamentous  influence not always is efficient. Laser treatment and surgery remain the most effective methods of suspension of development of glaucoma and preservation of sight.
Corectomy.
It is the laser technique directed to treatment of closed-angle  glaucoma. At corectomy carry out a tiny laser opening in an eye iris of the eye for creation of additional outflow of intraocular liquid. Carry out corectomy in out-patient conditions.
Not getting deep scleroticectomy (NGSE).
It is surgery of not getting type — without opening of an eyeglobe. During this procedure use not a through opening, and create the special valve in an outside cover of an eye — a sclera through which free outflow of intraocular liquid is possible. It allows to recover balance of liquid in an eye and to normalize pressure. Operation is performed on an outpatient basis and it does not provoke development of a cataract. The term of rehabilitation of patients after NGSE makes several days.
Viskokanalostomiya.
The operation, very popular now in Europe and the USA, directed to stabilization of sight at glaucoma. Treats surgeries of not getting type. Its purpose — recovery of physiological outflow tracts of liquid by creation of special "window" in a sclera.
Its main difference from NGSE consists that for recovery of outflow of liquid enter special viscous substance into drainage tubules — Gealon (Artivisk). Expanding a gleam of drainage tubules, Gealon recovers passability of moisture and allows to recover balance of liquid without opening of an eyeglobe. Operation is carried out on an outpatient basis, without provoking development of a cataract. Terms of rehabilitation of patients make 1–2 days.