Closed-angle glaucoma

Description:

Closed-angle glaucoma – rather rare form of glaucoma at which pressure in an eye rises too quickly. Closed-angle glaucoma generally at far-sightedness at aged people is more senior than 30 years.

Symptoms of Closed-angle glaucoma:

The course of closed-angle glaucoma at most of patients is characterized periodic, by short-term, and then more and more long periods of increase in the intraocular pressure (VGD) in the beginning. In an initial stage it is caused by mechanical closing of a zone of a trabecula with an iris root that is caused by anatomic predispositions of an eye. At the same time outflow of intraocular liquid (VGZh) decreases. At full closing of a corner of an anterior chamber there is a state called by a bad attack of closed-angle glaucoma. In intervals between attacks the corner opens.

During similar attacks commissures between an iris and a wall of a corner of an anterior chamber gradually form, the disease gradually gets a chronic current with continuous increase in the intraocular pressure (VGD).

During a closed-angle form of glaucoma it is possible to allocate such phases as:

  1. preglaukoma;
  2. bad attack of glaucoma;
  3. chronic course of glaucoma.

Preglaukoma occurs at persons who have no clinical displays of a disease, but at a research of a corner of an anterior chamber it is found out that it either narrow, or closed. During the period between preglaukomy and a bad attack of glaucoma passing symptoms of visual discomfort, emergence of iridescent circles at a view of a light source are possible, short-term loss of sight. Most often these phenomena arise at long stay in the dark or contagious excitation (these states promote a mydriasis that in whole or in part reduces outflow of intraocular liquid) and usually disappear independently, without causing great concern in patients.

The bad attack of glaucoma arises under the influence of provocative factors, such as nervous tension, overfatigue, long stay in the dark, a medicamentous mydriasis, long work in situation with a ducking, reception of a large amount of liquid. Sometimes the attack appears for no apparent reason. The patient complains of eye pains and in the head, sight misting, emergence of iridescent circles at a view of a light source. Pain is caused by a prelum of nervous elements in a root of an iris and a ciliary body. The visual discomfort is connected with cornea hypostasis. At sharply expressed attack nausea and vomiting can develop, the pains giving to the area of heart and stomach, sometimes imitating displays of cardiovascular pathology sometimes disturb.

At visual survey of such eye without special devices it is possible to notice only sharp vasodilatation on a front surface of an eyeglobe, an eye becomes "red", a little with a bluish shade (a congestive injection of vessels). The cornea because of edematization grows turbid. The pupil expanded and not reacting to light attracts attention. At height of the played attack visual acuity can sharply decrease. Intraocular pressure can increase to 60 - 80 mm of mercury., outflow of liquid from an eye stops almost completely. To the touch eye dense as stone.

Reasons of Closed-angle glaucoma:

The contributing factors of development of this form of glaucoma  are:

  1. anatomic predisposition;
  2. functional factors of closing of a corner of an anterior chamber;
  3. age changes in an eye.

As the anatomic features of a structure of an eyeglobe contributing to development of closed-angle glaucoma serve the small size of an eye, a small anterior chamber, a big crystalline lens, a narrow corner of an anterior chamber, far-sightedness. Refer increase in products of intraocular liquid (VGZh), increase in a krovenapolneniye of intraocular vessels, a mydriasis to functional factors.
There is a large number of medicines which can increase risk of development of closed-angle glaucoma, and especially the tranquilizers applied at treatment of a depression and other psychiatric frustration.

Treatment of Closed-angle glaucoma:

Quickly to reduce pressure in an eye during a bad attack of closed-angle glaucoma, several drugs are used. The use inside on doctor's orders of mix of glycerin and water reduces high pressure and stops an attack. Karboangidraza inhibitors, for example Diacarbum, are also effective if they are accepted at an early stage of an attack. Eye drops with Pilocarpinum narrow a pupil, straighten an iris, thus opening channels of outflow. Eye drops with beta adrenoblockers also use to control pressure in an eye. After an attack treatment is usually continued: appoint eye drops and intake (orally) of several doses of inhibitors of a karboangidraza. In hard cases to reduce pressure, intravenously enter Mannitolum.

The laser surgery by means of which the opening in an iris is created provides a liquid drainage from the back camera to area of a corner of an anterior chamber. It helps to prevent further attacks and often allows to cure a disease. If the laser surgery does not solve a problem, perform operation. When channels of outflow narrow in both eyes, treat two eyes at once even if attacks strike only one of them.