glaucoma

Glaucoma




It is a group of ophthalmic disorders consisting in a slow and progressive optic neuropathy of optic nerve and the retinal ganglion cells failure. The pathogenesis of this disease depends on the type of glaucoma - most frequently it leads to permanent damage of nerve cells by increased intraocular pressure. This is caused by increasing the amount of aqueous humor (an imbalance in the production-adsorption). Blocking outflow of aqueous humor causes a significant increase in intraocular pressure and consequently to optic nerve damage (mechanical compression). Other causes of glaucoma may include atherosclerosis vessel walls that supplying optic nerve - chronic ischemia of neurons leads to their gradual failure and in the the last step to blindness. Factors predisposing to disease: the existence of a family, black race, age over 35 years old, high or low blood pressure, hypercholesterolemia, migraine, stress, sleep apnea, increased intraocular pressure, cardiac arrhythmia, cardiovascular disorders, retinopathy, trauma.


Types - etiology



a) glaucoma with normal intraocular pressure - glaucoma, which is caused by vascular changes, intraocular pressure does not deviate from the norm;

b) secondary glaucoma - caused by others causes; it is created within the pathological eye;

c) glaucoma with open angle glaucoma (glaucoma simple) - symptoms are often minimal or absent, it is open angle glaucoma (blockage is only the microstructure), and the process lasts for years;

d) angle-closure glaucoma (acute glaucoma) - after a violent attack of closure of the outflow of aqueous humor, often accompanied by severe pain and disorders vision correctness;
e) pigmentary glaucoma - is blockage drainage holes of aqueous humor pigment granules. They are created when the iris too much comes close to the lens (the attack may lead to physical exercise).


Symptoms



Loss of peripheral vision, occasional headaches, blindness, severe eye pain, nausea, vomiting.


Treatment



a) pharmacotherapy (mainly used for treatment glaucoma with open angle glaucoma) - parasympathomimetic drugs (e.g. pilocarpine), β-blockers (eg. timolol), carbonic anhydrase inhibitors (eg. acetazolamide), α2-agonists, prostaglandin analogs;

b) laser operation - trabeculoplasty and irydotomia;

c) surgery - trabeculectomy, irydectomy, scleroiridectomy,
cycleodiathermy, cycleocryopexiogoniotomy, photocoagulation.

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