The causes of glaucoma are not yet studied until the end. The term "glaucoma" invented by Aristotle, and before Hippocrates called the disease the term "glaukozis" (the color of sea water) due to dark green color dilated pupils, characteristic of the disease.

What is glaucoma

In accordance with modern concepts glaucoma - a chronic disease of the eye, the main manifestation of which is the increase in intraocular pressure (IOP). IOP can be increased continuously or periodically raise, in any case, the disease is accompanied by a violation of the outflow of intraocular fluid and long-term course of the optic nerve degeneration occurs with the development of blindness.

Glaucoma may be primary and secondary. Primary glaucoma is considered that if the dysregulation of intraocular fluid leads to the appearance of symptoms characteristic of the disease. In secondary glaucoma intraocular pressure violation occurs against existing ocular diseases, e.g., against inflammation, eye injury and so on. But many researchers are inclined to think that the distinction between primary and secondary glaucoma blurred, as many diseases that can lead to glaucoma, is not always easy to detect.

According to statistics, every sixth or seventh patient, who lost his eyesight, glaucoma is ill. Developing this disease more often in the second half of life. However, there are such things as youth and congenital glaucoma.

By the development of glaucoma can cause a variety of diseases, however, all types of glaucoma are combined the following characteristics:

• continuous or intermittent increase in intraocular pressure;
• development of degenerative disorders of the optic nerve as a result of constant pressure on a large volume of intraocular fluid;
• development of characteristic visual impairment.

Glaucoma - the cause of the

Reasons for glaucoma has not been studied until the end, but today it is believed that the disease may result from a whole range of reasons. Of particular importance among the causes of glaucoma takes the family history and congenital anomalies (or especially) the development of the organ of vision. Equally important is the condition of the circulatory system and the neuroendocrine system. Thus, under the influence of a number of factors lead to abnormalities, which eventually leads to severe disease - glaucoma.

The causes of primary glaucoma is still unclear, however, established risk factors affecting its beginning and promoting development.

To the development of secondary glaucoma can cause diseases such as cancer, infectious and inflammatory processes in the eye (usually bacterial or viral character), displacement of the lens, cataract Cataracts - how to solve the problem completely? , Metabolic and degenerative processes (atrophy of the iris, the effects of bleeding in the eye, and so on), blunt trauma, open wounds (including accession infection), thermal and chemical burns, surgical operations.

Congenital glaucoma Glaucoma - a perspective possible blindness   occurs when fetal anomalies of the eye, caused by various diseases or intoxication (for example, due to the introduction of drugs), developing in a woman's body during pregnancy.

What changes occur in the eye in glaucoma

Our eye is arranged so that its tissues are constantly washed by the aqueous humor, the presence of which is necessary for normal functioning of the body. The main reservoirs of aqueous humor are the anterior and posterior chambers of the eye. The front camera is located between the cornea and iris, and back - between the iris and lens.

In the corner of the front of the camera is a complex system of drainage, which allows to remove the excess moisture from the eye. Normally, in this area there is a balance between the formation and the outflow of the liquid, resulting in the anterior chamber maintained at a constant pressure of approximately 16 to 22 millimeters of mercury.

But glaucoma drain fluid or broken due to blockade access to outflow pathways or due to a change in the system outflow. This increases the pressure in the eyeball, it begins to compress the optic nerve, which gradually leads to the development of his first-degenerative metabolic processes, and then (in the long course of the disease) to full atrophy. At first sight it just reduced by narrowing the field of view, and then (atrophy) comes complete blindness.

Glaucoma - a disease that can develop slowly, imperceptibly and lead at the same time to complete blindness.

Galina Romanenko

Drug treatment of glaucoma always start with the appointment of local medicines. These drugs are drops from glaucoma. Modern drugs for local application may well restore normal intraocular pressure (IOP) in the initial stages of the disease.

Eye drops for glaucoma - their types

For drugs that improve the outflow of intraocular fluid include prostaglandin F-2a holinomimetiki, agonists.

For drugs that inhibits the production of intraocular fluid are selective sympathomimetic, beta-blockers (non-selective and selective) and carbonic anhydrase inhibitors.

There is also a combined glaucoma eye drops, which include several drugs - their action is often the most effective.

Preparations from glaucoma improving outflow of intraocular fluid

Prostaglandin F-2a - is latanoprost (Xalatan, 0, 005%), travoprost (Travatan, 0, 004%). They reduce IOP by improving outflow of intraocular fluid drainage outflow, so are used to treat open-angle glaucoma Open-angle glaucoma - occurs often goes unnoticed   (in violation of the cross drainage paths). These drops instilled once a day (in the evening). Contraindicated drugs of this series during pregnancy and breastfeeding, secondary glaucoma Secondary glaucoma - against the backdrop of another disease   amid inflammatory diseases of the eye after intraocular operations.

Holinomimetiki - a 1-2-4% pilocarpine hydrochloride and 1, 5% or 3% karbohol. Pilocarpine causes constriction of the pupil, ciliary muscle contraction, reducing the thickness of the iris, open access to the drainage area and improve the outflow of intraocular fluid. It is used in the treatment of open-angle glaucoma and closed-forms, including an acute attack of glaucoma. Pilocarpine eyedrops depot instilled twice daily.

Adrenomimetiki - 1-2% epinephrine (adrenaline hydrochloride). Helps to improve the outflow of fluid drainage system, slightly inhibits the formation of intraocular fluid. Local side effects: mydriasis, conjunctival redness and edges of the eyelids, allergic conjunctivitis, decreased blood flow in the optic disc.

Drops from glaucoma, depressing production of intraocular fluid

For drugs that inhibits the production of intraocular fluid, are selective sympathomimetic, beta-blockers (non-selective and selective) and carbonic anhydrase inhibitors.

The selective sympathomimetic - clonidine and brimonidine aproklonidin. Caused an improvement of intraocular fluid, as well as a reduction of intraocular fluid secretion. Clonidine (clonidine) causes a decrease in IOP, which starts in half an hour and lasts up to 8 hours. Recommended instilled three times a day.

The non-selective blockers. For nonselective (acting indiscriminately) in-blockers include timolol (0, 25 and 0, 5% timolol maleate). The drug is also available under the names arutimol, niolol, okumed, okupres-E, Okura, optimol, oftan-timolol, oftensin, timogeksal, timolol-PIC timoptik, timoptik depot. The mechanism of action is associated with a reduction in the formation of intraocular fluid. Lowering IOP occurs within 20 min after instillation and lasts for at least 12 hours. Recommended instilled 1-2 times a day.

In-selective blockers (acting selectively). These include betoksolol (Betoptik 0, 5%, Betoptik 0 C, 25%). Side effects - a burning sensation and pain in the eyes sometimes - decreased corneal sensitivity. The drug should be used with caution for patients with diabetes Diabetes - threatening and incurable disease , Hyperthyroidism, bronchial asthma Bronchial asthma - the body's response inadequate .

Carbonic anhydrase inhibitors cause a decrease in the formation of intraocular fluid and lowering the tone of the eyeball. Azopt 1% ​​(1% solution brinzolamide) - IOP reduction occurs within 15-20 minutes after instillation of the drug and lasts 12 hours. Mode instillation - twice a day.

Drops for the treatment of glaucoma combined

Combination medicaments for treating glaucoma are composed of drugs with different mechanisms of action, which are mutually strengthened:

• fotil; it consists of a solution of 0, 5% solution of timolol and pilocarpine 2%; after instillation of IOP reduction begins with the second hour, the maximum effect after 3-4 hours, the duration of the therapeutic effect - 12 hours; recommended - 1-2 times a day; no side effects;
• ksalakom - combined formulation comprising a solution of 0 005% solution of latanoprost and 0, 5% timolol maleate; has a strong IOP lowering effect that persists for a day, it is recommended to dig 1 times a day (in the morning);
• normoglaukon - a combination of 2% pilocarpine solution with 0, 1% sodium metipranolol; IOP reduction begins an hour after a single instillation persists for days;
• proksofelin - combined preparation, which comprises proksodolol and clonidine, has a potentiated hypotensive effect mainly by inhibiting the production of intraocular fluid;
• proksokarpin - consists of a 1% solution proksodolola and 1% pilocarpine solution; IOP reduction begins 30-60 minutes after instillation, persists for days.

Eye drops for glaucoma prominent place in the treatment of this disease.

Galina Romanenko