Glaucoma. Causes, symptoms, treatment

What is glaucoma?

Glaucoma is a group of conditions characterized by the progressive destruction of the optic nerve fibres responsible for transmitting information from the eye to the brain, resulting in a gradual narrowing of the field of vision and eventually blindness.

There are two major types of glaucoma:

• Angle-closure glaucoma (the circulation of aqueous humor is suddenly blocked; the rapid accumulation of this fluid can cause rapid, severe and painful pressure; it is an urgent problem)
• Open-angle glaucoma (causes no symptoms; this problem can progress so slowly that vision may be irreversibly damaged before any other signs appear)

Glaucoma is most common in older patients (in the over 75 age group, the prevalence of glaucoma is 3%), but it can also develop in children, even newborns.

The amount of fluid entering the eye must drain. The fluid drains through an area called the drainage angle. This process keeps the pressure in the eye (called intraocular pressure) stable. But if the drainage angle doesn't work properly then fluid builds up and the pressure inside the eye rises, damaging the optic nerve. The optic nerve is made up of more than a million tiny nerve fibers. It is like an electrical cable made up of many tiny wires. As these nerve fibers die, you will develop "blind" spots. You may not notice these blind spots until most of the nerve fibers have died.

The disease develops because:

• damage to the circulation of aqueous humor, leading to a dysregulation of its flow out of the eye;
• excess tolerogenic IOP (intraocular pressure);
• death of the optic nerve and retinal ganglion cells.

The insidiousness of the disease is that many cases of glaucoma remain undiagnosed even in advanced stages. At the same time, visual acuity decreases by 10% every year and complete damage to the optic disk takes 1-2 years.

Early diagnosis of the disease and appropriate therapy can maintain vision for as long as possible.

Glaucoma exists:

1. primary;
2. secondary;
3. congenital, which includes early, infantile and juvenile glaucoma.

People at risk of developing glaucoma are:

• the elderly;
• people with a family history of glaucoma;
• Negroid race;
• those taking glucocorticosteroids (GCS - part of the category of drugs banned in glaucoma);
• people with high intraocular pressure (IOP).

Glaucoma symptoms

Open-angle glaucoma is characterized by involvement of both eyes. The disease usually begins after age 35 and progresses asymptomatically. You may notice:

• episodes of blurred vision;
• blind spots, which eventually grow and merge into a single spot;
• sensation of tension in the eyes;
• loss of peripheral vision.

Angle-closure glaucoma develops after the age of 40 and accounts for 20% of other types of glaucoma. It is characterized by acute attacks that occur from time to time. Signs of angle-closure glaucoma:

• Severe pain in the eye;
• rainbow circles in front of the eyes;
• redness of the eyes;
• blurred vision.

In glaucoma, there may also be common symptoms: eyestrain in the evening, a feeling of heaviness in the eyes, fatigue during visual stress, tearing or watering of the eye in the absence of tear duct pathology.

Glaucoma treatment

In the later stages of the disease, irreversible loss of vision occurs. The only treatment is a decrease in IOP to prevent pathologic processes in the visual apparatus. For this, glaucoma drugs and surgical methods are used.

If, as a result of drug therapy, IOP cannot be reduced, surgical treatment is necessary. Laser cyclophotocoagulation and classical surgery are used to treat glaucoma.

Antihypertensive drugs

IOP-lowering drugs - prostaglandins, non-selective and selective β-blockers, α-adrenergic agonists, local and systemic carbonic anhydrase inhibitors. Local remedies for glaucoma are used in the form of eye drops. All these remedies can be found in the eye drops section on our situ-l.

First-line medicines

Prostaglandins increase intraocular fluid flow - Monopost, Lumigan. They are the most effective, safe and convenient to use: they only need to be applied once a day in the evening.

Their prolonged use can lead to ocular irritation. Alocross can help.

Alocross eye drops, 8 ml, Off Italia

22

£13.70

Buy

Alternatively, use selective beta-blockers that reduce intraocular fluid production - Betaxolol, Timolol, Fortinol. Drops are used twice a day, only work throughout the day, but may cause side effects.

Second-line drugs

α-adrenergic receptor agonists increase outflow and reduce intraocular fluid production - Simbrinza, Brimonal.

Topical carbonic anhydrase inhibitors (Azopt, Azarga) act by inhibiting fluid production.

Antihypertensive therapy (IOP lowering) is performed 2-3 times a year for 1-2 months while alternating medications.

To relieve an acute attack and headache in glaucoma, systemic carbonic anhydrase inhibitors are taken, for example, acetazolamide in tablets.

It is complicated to choose the best drops for glacoum, as everything is particular from case to case.

Glaucoma prevention

Even though there is no cure for glaucoma, because the exact causes leading to the onset of the disease are not known, specialists mention a few recommendations for preventing the condition.

• Regular eye check-ups. This is all the more important if you have risk factors or family members suffering from the condition.
• Healthy lifestyle and balanced diet with regular physical exercise can regulate intraocular pressure.
• Vitamin and nutrient intake is vital.
• Eliminate stress factors, relax with different meditation techniques and therapies.

Glaucoma is a condition that can progress over time and can lead to blindness in severe cases. Diagnosis of this health problem is made by a specialist after a whole series of specialized investigations, and individualized treatment can help maintain vision.