Secondary glaucoma
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Description:
Secondary glaucoma is a consequence those enough numerous diseases or injuries of eyes which are followed by development of organic changes in its drainage system.
Symptoms of Secondary glaucoma:
Clinical displays of posttraumatic secondary glaucoma are various. Changes of a front piece of an eye depend on the nature of injury of an eye and its effects. The rough hems of a cornea and corneal and scleral area soldered to an iris, the shift and change of a form of a pupil, back synechias, defects of an iris, a traumatic cataract or an aphakia, an opacity of the vitreous body, etc. can be observed. Characteristic symptoms of posttraumatic secondary glaucoma are the congestive injection, the increased intraocular pressure, cornea hypostasis, decrease in visual acuity, narrowing of a field of vision. At a gonioskopiya come to light mechanical partial or full closing of a corner of an anterior chamber with hems, deposits rough глыбок a pigment in a zone of corneoscleral trabeculas, etc. Glaukomatoznaya excavation appears, as a rule, in far come stage.
Reasons of Secondary glaucoma:
Distinguish the following types of secondary glaucoma: 1) Secondary glaucoma owing to anomaly of development: inborn glaucoma (hydrophthalmia); glaucoma in combination with mikroftalmy, an aniridiy, flat iris. 2) Secondary glaucoma owing to inflammatory process in an eye. 3) Secondary glaucoma owing to changes in a crystalline lens: traumatic incomplete dislocation and dislocation of a crystalline lens; swelling of a crystalline lens; rassasyvany substances of a crystalline lens (phacolytic glaucoma). 4) Secondary glaucoma owing to vascular diseases of eyes: occlusion of the central vein of a retina (posttrombotichesky glaucoma); neovascular glaucoma at diabetes, retina amotio; glaucoma against the background of a hyphema and a hemophthalmia. 5) Secondary glaucoma owing to degenerations and dystrophies: pigmental dystrophy of a retina. 6) Secondary glaucoma owing to intraocular and orbital tumors and cysts. 7) Traumatic glaucoma: after a contusion of an eyeglobe, perforated wounds, intraocular foreign bodys; glaucoma after operations on an eyeglobe (extraction of a cataract, a keratoplasty). 8) The glaucoma connected using some pharmacological means expanding a pupil, hormones of streptocides.
Most often forms of the secondary glaucoma developing as a result of the postponed iridocyclitis with the expressed fusion of a pupil meet; against the background of the bulking-up cataract; after thrombosis of the central vein of a retina.
Treatment of Secondary glaucoma:
Drug treatment of posttraumatic secondary glaucoma in connection with the rough changes interfering outflow of intraocular liquid, as a rule, ineffectively or gives temporary effect. Miotocs can lower and even to normalize intraocular pressure only in very small percent of cases. The drugs reducing secretion of intraocular liquid (Diacarbum) give temporary hypotensive effect. In this regard treatment of secondary glaucoma, as a rule, surgical.
Apply reasonable operations microsurgical pathogenetic. Surgical intervention is chosen depending on a pathogeny of increase in intraocular pressure. In the presence of the cicatricial unions in an anterior chamber interfering outflow of intraocular liquid make its reconstruction. If a major factor of increase in intraocular tension is crystalline lens pathology (an incomplete dislocation, dislocation in a vitreous, swelling of lenticular masses), then delete it, applying microsurgical methods, including a fakoemulsifikation, a lensktomiya, etc. At the vitrealny block make a vitrectomy (front, back the closed type), at angular and other forms - antiglaukomatozny operations (an iridotsikloretration, an iridosklerektomiya, fistuliziruyushchy, etc.). At the mixed pathogeny apply a combination of interventions.
