It happens that during routine examinations to detect early signs of cataract, but the patients themselves have not noticed any of its symptoms. Most often it happens that the patients themselves notice blurred vision caused by cataracts - this usually occurs over the age of 40 years. In most of these cases, doctors recommend that patients undergo regular examinations and cataract surgery can be assigned only many years later, after her first symptoms appeared.

When do the surgery for cataract

Cataract surgery is recommended for most people who have cataracts resulted in a significant impairment of vision. If the patient has another serious eye disease not associated with cataracts, which also leads to deterioration of vision, surgery may be contraindicated. However, all possible contraindications cataract surgery are considered separately in each case. For example, sometimes because of cataract doctor can be difficult to see the retina survey appointed after an eye injury, or undergoing surgery earlier in his eyes. In such cases, during a single operation can remove the cataract and to evaluate the condition of the retina or optic nerve, and if necessary, an additional treatment.

Moved before refractive surgery such as laser vision correction Laser vision correction - what is the most effective way? , Is not a contraindication to the cataract.

Types of cataract operations

Standard cataract surgery is performed on an outpatient basis, and the whole operation takes less than thirty minutes.

• Phacoemulsification cataract - the most common current methods of treatment for this disease. As a rule, they are used only for anesthesia analgesic eyedrops and light sedation. Looking operated area in a special microscope, the surgeon makes a very small incision in the eye, and enters through the probe. Focused ultrasound waves destroy the lens of the eye, followed by aspiration Aspiration: the main thing - do not get confused   fragments using all of the same probe. After the lens is removed, it is replaced with an artificial lens. As a rule, ultrasonic phacoemulsification cataract completed without sutures and dressings;
• Extracapsular cataract extraction. This operation is usually needed only in cases where due to cataract lens has become so dense that it can not be removed using phacoemulsification. To carry out such an operation requires large incisions through which the lens can be removed entirely, not dividing it into fragments. After removing the lens of his capsule and put an artificial lens. To have a normal incisions heal, usually require a few stitches, and recovery from such an operation is slower than after phacoemulsification. Before the start of operation of this type in the skin around the eyes is usually administered a local anesthetic, and after its completion on the operated eye bandage;
• Intracapsular cataract extraction - is even more invasive surgery in which the surgeon removes the lens along with the capsule. Artificial lens can be implanted in the anterior chamber or in the pupillary aperture. Today, this method is rarely used and often not for the treatment of cataracts, and to eliminate the consequences of the serious injuries of the eyeball.

Replacement lens for cataract

Since the lens is essential for focusing light impinging on the retina and a clear image, after cataract surgery conducted usually produce implantation of artificial lenses, or intraocular lenses. As the artificial lens is placed in the same place where a real lens has been removed, or near, vision is restored, and peripheral vision, depth perception and other characteristics remain the same view. Usually after installing artificial lenses additional action is required; the patient does not feel them, and for others they are invisible. There are several types of artificial lenses, for example:

Monofocal intraocular lenses. Artificial lenses of this type are now used more often. They have the same optical power at all portions of the lens, and provide good distance vision. In order to see well and at close range, patients usually wear glasses. Monofocal lenses do not correct astigmatism - a disorder in which the cornea has an irregular shape, which leads to more or less significant visual impairment. If necessary, the doctor can correct astigmatism during cataract surgery.

Toric intraocular lenses have the highest optical power at a certain area, and can be used in cases where a patient diagnosed cataracts Cataracts - how to solve the problem completely?   and astigmatism. Although toric lenses to improve distance vision and eliminate eye problems associated with astigmatism after surgery patients will still need to wear glasses for tasks requiring near vision acute, such as reading, writing, and so on.

Multifocal lenses have different optical power at different sites, which provides a person a good vision at different distances. Although it sounds promising, multifocal lenses are not for everyone: they cause more distortion than monofocal and toric lenses and is not suitable for patients who in addition to cataracts diagnosed astigmatism Astigmatism - lenses, glasses or surgery? .

Angle-closure glaucoma Glaucoma - a perspective possible blindness   often it occurs in the form of acute attacks of glaucoma and is a medical emergency. With each attack in the tissues of the eye and the optic nerve, irreversible changes that could lead to blindness, including developing a sudden, during the attack.

Why develop angle-closure glaucoma

Angle-closure glaucoma develops at the root of the iris blocking the angle of the anterior chamber of the eye. This overrides the output of intraocular fluid from the eye for drainage system, promotes the development of intraocular pressure and adhesion in this area. Angle-closure glaucoma occurs much less frequently of open.

During the angle-closure glaucoma is divided into four stages, which are defined as the optic nerve during the examination of the fundus and visual fields:

• Stage I - initial; There are no excavation (deepening) of the optic nerve, and changes in the peripheral visual field boundaries;
• Stage II - development; you can see the initial manifestations of the excavation, the narrowing of the peripheral borders of the visual field;
• Stage III - advanced stage; excavation of the optic phenomenon intensified, and there are violations not only peripheral, but central vision;
• Stage IV - terminal; eye drops to light perception or complete dysfunction of view.

Contributing factors are the same farsightedness (it is characterized by shallow anterior chamber and a large lens), age over 40, family history (glaucoma in close relatives).

Symptoms

The current angle-closure glaucoma is often accompanied by acute attacks of glaucoma. Acute glaucoma attack can be triggered by stress How to beat stress? Create an oasis , Physical activity, dilated pupils (eg, accidental drops instillation of expanding the pupil or stay in the dark), abundant fluid intake, consumption of salty foods, hypothermia, prolonged stooping down, squeezing, alcohol abuse, frequent smoking.

The attack begins with the appearance of growing pains in the orbit, donating to the temple and forehead. At the same time may appear blurred vision in the form of a fuzzy vision of objects, the appearance of bright circles when looking at the light source, flying "flies" in front of the eyes, etc .. In severe attacks occur a temporary complete loss of vision, which can last from several hours to several days . Sometimes vision after severe attacks of glaucoma can not be restored. There are also autonomic symptoms in the form of reduced heart rate, nausea, vomiting, sweating.

Visual acuity at an acute attack of glaucoma is reduced due to swelling of the eye tissues, including corneal edema - patient sees everything as through a glass darkly, hampered investigation of the fundus. Pupils dilated, sometimes they have an elongated oval shape, the reaction of pupils to light is reduced. The iris swollen, reddened, and the condition of the lens is changed - there appear spots, which also reduces visual acuity.

Intraocular pressure increases to significant digits (sometimes to 80 mm Hg. V.), Which leads to constriction of blood vessels of the iris and the development therein of necrosis (tissue necrosis) that changes the shape of the pupil, an inflammatory disorder, occurrence of adhesions, Development cataract and abuses by the optic nerve.

In less severe acute attack of glaucoma appears blurred vision and the appearance of bright circles when looking at the light source. Edema is expressed with a much lesser degree, the pupil expanded, but loses its shape (tissue necrosis does not occur). Intraocular pressure is less than 40 mm Hg. Art.

The flow of an acute attack of glaucoma moderate severity accompanied by a rise in intraocular pressure of 60 mm Hg. Art., the emergence of pain in the eye and brow arch, severe headache.

Based on what the diagnosis is angle-closure glaucoma

The diagnosis is made by the complaints of the patient, his story about the course of the disease, the presence of glaucoma in close relatives, the characteristic signs of the disease. Confirms the diagnosis function test results of the eye (the state of the peripheral and central visual field) of the fundus (the presence of abnormal deepening of the optic nerve), the presence of elevated intraocular pressure and vibrations within 5 mm Hg. Art. during the day.

Treatment

An emergency task is to reduce the intraocular pressure, which leads to the restoration of normal blood circulation and metabolism Metabolism: The basis of life of all living things   in eye tissues and nerve fibers of the optic.

Total conservative treatment of primary angle-closure glaucoma is the appointment of drugs that enhance metabolism Improves metabolism and losing weight without dieting   in eye tissues, vasodilator drugs, if necessary - diuretics.

With the ineffectiveness of conservative treatment operation is conducted - iridectomy (deleted iris, blocking the outflow of intraocular fluid).

Galina Romanenko