Glaucoma - operation in this severe chronic disease is carried out when the conservative treatment is ineffective, the state of the optic nerve and of progressively deteriorating. Glaucoma treatment without surgery, in this case ineffective.

Surgical treatment of glaucoma

In some cases, the treatment of glaucoma can not do without surgery. Skilled is well known, so today there are many types of operations and procedures in glaucoma. The indications for surgery is the lack of effect of conservative treatment, high intraocular pressure (IOP - more than 22 mm Hg), differences in IOP throughout the day to 5 mm Hg or more, the deterioration of the optic nerve. If any such indication refusal of operation eventually leads to a complete loss of vision.

The main goal of surgical treatment of glaucoma is elevated IOP normalization, creation of conditions for the outflow of intraocular fluid, as well as favorable conditions for the functioning of the optic nerve, eliminating the effects and consequences of pinched nerve, improving its blood supply and tissue metabolism.

Types of operations for glaucoma

All operations in glaucoma can be divided into four types:

• fistuliziruyuschie (penetrating) operations, of which the most common trabeculectomy; In this operation, in the wall of the eyeball is a hole (fistula) for permanent drainage cavity of the eye;
• nefistuliziruyuschie (non-penetrating) operations; an example of such an operation is penetrating deep sclerectomy (NSGE); the integrity of the eyeball is not broken, diversion of fluid from the eye is due to a small area of ​​the scleral thinning through natural pores;
• operations normalizing circulation of intraocular fluid inside the eyeball; such operations are iridectomy, iridotsikloretraktsiya and some others;
• operation aimed at reducing the production of intraocular fluid; This tsiklokriokoagulyatsiya and laser tsiklokoagulyatsiya.

Operations at the open-angle glaucoma

Open-angle glaucoma Glaucoma - a perspective possible blindness   characterized by the fact that the violation of the outflow of intraocular fluid from the anterior eye chamber is due to "failures" in the drainage system, through which removes excess moisture nome. Today, with open-angle glaucoma Open-angle glaucoma - occurs often goes unnoticed   often held penetrating deep sclerectomy (NPDS). This surgery is much less traumatic fistuliziruyuschey normal operation as carried out without compromising the integrity of the eyeball.

NDSE advantages are the lack of a gross violation of the natural mechanism of intraocular fluid, the IOP decreased to normal and remained stable at this level, it is possible to carry out several operations in one eye (eg NDSE and cataract), low risk of infection and postoperative complications

Operations at the angle-closure glaucoma

When angle-closure glaucoma Angle-closure glaucoma - possibly severe course of the disease   dregazhnaya stsema eye works fine, but access to it is blocked iris. This type of glaucoma is most often performed surgery iridectomy.

Corectomy - is excision of the iris of the eye through an incision in the cornea or sclera. Produced with the aim of reducing the intraocular pressure in glaucoma by eliminating pupillary block and create a new way of intraocular fluid.

Operations aimed at reducing the production of intraocular fluid

Tsiklokriokoagulyatsiya is the destructive impact of cold on the ciliary body. As a result of the ciliary body tissue exposed to low temperatures, partially atrophied. This leads to the fact that the ciliary body after some time after the operation starts to produce fewer intraocular fluid, which leads to lower IOP.

When laser tsiklokoagulyatsii reduction of intraocular fluid secretion is achieved by acting on the ciliary body of the laser beam. The operation is performed on an outpatient basis under local anesthesia. The therapeutic effect develops after a few days. If necessary, laser tsiklokoagulyatsiyu repeated once a week.

Glaucoma - the postoperative period

After antiglaucomatous operations (some patients referred to them as "the removal of glaucoma") conducted to date, postoperative course is usually uneventful. In some cases, patients complain of blurred vision, which passes in a few days. Often close eye bandage or a special protective shield that is also removed after a few days. The patient within a month after the operation can not engage in heavy physical labor, to bend, lift weights. The rest of the recovery period passes without features.

Galina Romanenko

Glaucoma - a group that includes a variety of eye diseases that can damage the optic nerve and, in some cases, to loss of vision. Such damage is often, but not always, are caused by an abnormally high intraocular pressure.

Glaucoma is the second leading causes of vision loss. It can cause damage to a person slowly and occasionally her symptoms only when the disease is in the later stages of development. In the most common type of glaucoma - open angle glaucoma, for a long time there are no symptoms other than a gradual loss of vision.

Early diagnosis and treatment can minimize or prevent damage to the optic nerve and to limit associated with glaucoma, vision loss. It is very important to be screened regularly by an ophthalmologist, in particular, to measure the intraocular pressure.

Symptoms

The two most common types of glaucoma - open-and-closure glaucoma - a completely different symptoms. Primary open-angle glaucoma symptoms are:

• The gradual deterioration of peripheral vision, usually in both eyes.
• Tunnel vision - in the later stages of the disease.

Symptoms of acute angle-closure glaucoma:

• Severe pain in the eyes
• Nausea and vomiting
• Sudden blurred vision often - in low light
• Blurred vision
• Halos around lights
• Red whites of the eyes

When at least two symptoms of acute angle-closure glaucoma should immediately seek medical care.

Primary glaucoma is called (of any type), if the reason for its development is unknown. Secondary glaucoma develops as a result of eye injuries, inflammations, tumors, diabetes, and also in the late stages of cataract. In secondary glaucoma in a patient, along with the usual symptoms of glaucoma, and symptoms observed major violations.

Since the most noticeable symptoms of glaucoma Symptoms of glaucoma - it is important to notice in time   It appears only in the later stages of its development, need to undergo regular medical examinations in order to prevent this, and many other diseases.

Causes

For reasons that are not yet fully understood physicians, increased intraocular pressure is usually associated with damage to the optic nerve, which is characteristic of glaucoma. Pressure increases due to accumulation of too much aqueous humor, intraocular fluid, or which is constantly secreted in the anterior portion of the eye.

Aqueous humor is usually derived from the eye through a special system of drainage - where touching the iris and cornea. When the system is not working properly, the aqueous humor is displayed more slowly than usual, and the pressure inside the eye rises.

Who gets glaucoma

Most often, glaucoma occurs in people older than 40 years, although it may be ill and members of other age groups, including - pre-school children and even babies.

In addition, the risk of glaucoma is elevated in people with diabetes, poor vision, as well as those who are taking certain medications, such as prednisone.

Primary open-angle glaucoma

In primary open angle glaucoma the drainage angle between the iris and the cornea remains open, but the drains or the trabecular meshwork, partially blocked microscopic particles, and the outflow of the aqueous humor is too slow. This leads to fluid retention and increased pressure within the eye. Damage to the optic nerve occurs so slowly and painlessly that a significant loss of vision can occur before the person is aware of the problem.

Angle-closure glaucoma

This violation of the iris bulges forward, which is why the drainage angle is narrowed or blocked. Intraocular pressure thus increases faster than closed-angle glaucoma. The most common attack begins suddenly - an acute angle-closure glaucoma Angle-closure glaucoma - possibly severe course of the disease But sometimes this disease is chronic. Angle-closure glaucoma often develops in people who are born abnormally narrow drainage angle. However, this slight deviation can remain undetected for a lifetime, if not cause any problems.

However, the sudden dilation of the pupils in people with narrow drainage angle may be a trigger of acute angle-closure glaucoma. Pupils can expand due to darkness, low light, stress, arousal and certain drugs. For example, dilated pupils cause some antihistamines (cetirizine and desloratadine), tricyclic antidepressants, eye drops, drugs.

Glaucoma with normal intraocular pressure

Patients with this type of glaucoma, the optic nerve is damaged, but the intraocular pressure is within limits. The exact cause of this type of glaucoma is unknown. Possibly, the disease is a consequence of an increased sensitivity of the optic nerve, or disorders of blood flow to the optic nerve. The reason for the limited blood flow can be atherosclerosis or other diseases, blood circulation.

Congenital, infantile and juvenile glaucoma

Sometimes glaucoma is diagnosed in infants, older children and adolescents. In rare cases, children are born with glaucoma - a congenital glaucoma Congenital glaucoma - the boys get sick more often girls . It can also develop in the early months and years of life (infantile glaucoma), and after the age of 4-5 years (juvenile glaucoma). Usually, children, there are no symptoms of the disease. However, they may already be damaged to the optic nerve caused by primary or secondary glaucoma Secondary glaucoma - against the backdrop of another disease .

Pigmentary glaucoma

When pigment glaucoma pigment granules from the iris accumulate in the drainage channels (trabecular meshwork), slowing or blocking the fluid filter. Physical activity, such as jogging, sometimes lead to the fact that the pigment particles in the channels violate any fluid that causes a transient increase in intraocular pressure.