- Glaucoma treatment - should be timely and comprehensive
Glaucoma Treatment depends on the stage at which it was found. The most effective treatment of this disease in the early stages, in this case an adequate comprehensive treatment can completely restore the function of the organ of vision. If you do not start treatment on time, total blindness can occur.
How to treat glaucoma
The main goal of glaucoma treatment is to reduce intraocular pressure and stabilization of visual function. Treatment is usually selected for each patient individually depending on the stage of glaucoma
Stages of glaucoma - the types of disease
, Intraocular pressure, the degree of disturbance of visual function, the general condition of the patient, the presence or absence of concomitant diseases.
In addition to well-appointed physician adequate treatment matters and patient participation in treatment - he should understand how important it is to keep under the control of intraocular pressure and what the consequences might be if non-compliance with this condition. The importance of this point is that it is the patient must carefully carry out all the prescribing physician. In the case of pronounced symptoms of the disease (eg, acute glaucoma attack) the patient is almost always carries a doctor's prescription.
But certain types of glaucoma (e.g., open-) at the initial stages may be asymptomatic, which often leads to impaired performance of prescribing and reduction of visual functions. To avoid such complications, glaucoma patients should be aware of all the disease.
Methods for the treatment of glaucoma can be medication, laser and surgical.
Choice of treatment to be a doctor. How to cure glaucoma? Rather, it completely cure does not work, but it is really to maintain normal vision using different treatments.
Conservative treatment of glaucoma
Conservative treatment of glaucoma patients begin with a local hypotensive therapy - reduction of intraocular pressure with the help of drugs with local action.
Glaucoma - treatment of this disease may be different, however, there are general rules of treatment. For example, local medical treatment of glaucoma is carried out under the following rules:
- reduction of IOP should be stable - it will prevent decreased vision; thus, the more the optic nerve is damaged, the lower should be the level of IOP;
- since the drug may develop an addictive need to regularly monitor the effectiveness of treatment (studied and the state of the optic disc), and if necessary - correction of assignments;
- before treatment is determined individual level of IOP, which is required to achieve and maintain through medical treatment;
- Treatment always begins with the appointment of the drug of first choice; if it is impossible to assign (not pharmacy, patient allergies, and so on) is assigned a different drug or more (usually no more than two) drugs;
- treatment should be conducted throughout the life of the patient with periodic replacement of other drugs belonging to a different group of drugs with different mechanism of action.
The medicine for glaucoma may be applied topically, and orally or by injection (systemic action).
Local drugs for the treatment of glaucoma
All local medicines that lower IOP in glaucoma, can be divided into two groups: improving the outflow of intraocular fluid and reduce its formation.
For drugs that improve the outflow of intraocular fluid include prostaglandin F-2a (0, 005% latanoprost, 0, 004% travoprost) holinomimetiki (1-2-4% pilocarpine hydrochloride and 1, 5% or 3% karbohol) and agonists (1 -2% epinephrine).
For drugs that inhibits the production of intraocular fluid are B-blockers (0, 25 and 0, 5% timolol maleate, 0, 25, 0, 5%, Betoptik), carbonic anhydrase inhibitors (Azopt 1%, 2% trusopt), central agonists a2-adrenergic receptors (clonidine aproklonidin, brimonidine).
Widely used combination drugs for the treatment of glaucoma - fotiol, ksalakom, normoglaukon, proksofelin, proksokarpin. They are composed of drugs with different mechanisms of action, that is synergistic.
The advantages of the combined drugs are most antihypertensive efficacy, lack of addiction to the drug, reducing the number of instillation.
Preparations general (systemic) action for the treatment of glaucoma
The cure for glaucoma can be common action. Above all, this medication with osmotic action - glycerol, mannitol, urea, isosorbide. They are taken orally or injected intravenously. The mechanism of action of these drugs is associated with increased osmotic pressure in the blood, accompanied by a flow of fluid from the tissues into the blood, a decrease in edema, reduction in intraocular pressure and removing excess fluid
How to withdraw excess fluid from the body - all sorts of ways
through the kidneys (diuretic effect).
Thus, when using mannitol IOP decreases over time, the action is continued for 6-8 hours. Preparations of this group are widely used in the relief of acute attacks of glaucoma, preparing the patient for surgery, postoperative and the need to reduce corneal edema before the examination.
For removal of tissue edema apply other diuretics for example furosemide and carbonic anhydrase inhibitors (Diacarbum). Carbonic anhydrase inhibitors reduce the production vnurtriglaznoy liquid, which leads to lower intraocular pressure. Treatment of open angle glaucoma
Treatment of patients with open-angle glaucoma
Open-angle glaucoma - occurs often goes unnoticed
usually start with destination instillation solutions cholinomimetic agents, often 1% pilocarpine solution 2-3 times a day. This leads to an improvement of intraocular fluids and to lower intraocular pressure. If this fails, a prescribed instillation 2% pilocarpine solution three times a day.
With the lack of efficacy of treatment in addition designate Neostigmine, phosphacol, tosmilen to 2 times a day. Their action is also aimed at improving the outflow of aqueous humor from the eye.
If the patient has normal or low blood pressure
Blood pressure - dangerous if his swing?
, Then add to the introduction of pilocarpine 1-2% solutions of adrenaline. Assign as 3 - 5% solutions fetanola which has a long and gentle action on the blood vessels as compared to adrenaline. You can also use the 0, 5% solution of clonidine, a 1% solution of propranolol.
If topical treatment does not result in a sufficient reduction in IOP prescribed antihypertensives common action - carbonic anhydrase inhibitors (diakarb), osmotic agents (glycerol). and antipsychotics (chlorpromazine). Diakarb administered orally for three consecutive days with a break for 1-2 days.