Glaucoma

Glaucoma is a disease that causes damage to the optic nerve and as a result leads to vision impairment or blindness. This disease can occur at any age, starting at birth, but is most common in older people and older. Currently, there are no common ideas about the causes and mechanisms of this disease.

Glaucoma usually occurs due to an increase in intraocular pressure (IOP). In front of the eye, between the lens and the cornea, there is a small space called the anterior chamber. A clear liquid circulates in it, washing and nourishing the surrounding tissues. When intraocular fluid begins to flow too slowly from the anterior chamber, its accumulation causes an increase in intraocular pressure. If it is not controlled, it can damage the optic nerve and other structures of the eye, and then loss of vision.

Symptoms of glaucoma

In the early stages, most cases of open-angle glaucoma are not accompanied by any symptoms and manifestations: normal vision is preserved, there is no pain or other changes in well-being. Sometimes patients can complain about the temporary appearance of rainbow circles before the eyes, the phenomenon of asthenopia. Since they are not specific only for glaucoma signs, this can lead to an underestimation of the condition and, as a consequence, the delay in diagnosing the disease. However, despite the absence of symptoms in the early stages of the disease, irreversible damage can occur in the optic nerve.

If glaucoma remains undetected for a long time, then the symptoms described below may occur. The main one is the deterioration of peripheral vision. A person sees well in front of him, but objects located on the side and at an angle may not notice. Initially, the narrowing of the field of view occurs mainly from the nose, and in the future - can concentrically cover the peripheral divisions up to its complete loss. It is also possible the appearance of a translucent or opaque spot in the field of view.

The patient may notice a decrease in dark adaptation, which consists in deterioration of vision during a rapid transition from a brightly lit room to a darkened, and also, sometimes, the appearance of color disturbances. In some cases, there is an uncorrectable decrease in visual acuity, which already speaks of a severe, advanced stage of the disease, which is accompanied by a gradual atrophy of the optic nerve fibers.

The most vivid symptoms observed in acute attack of angle-closure glaucoma. In this case, the following manifestations of the disease can be detected:

pain in the eye and headaches radiating along the trigeminal nerve (frontal, zygomatic, temporal region);
blurred vision;
rainbow circles around light sources;
photophobia;
redness of the eye;
nausea and vomiting;
lowering the number of heartbeats.

It should be noted that often the overall symptoms are more pronounced than ocular. Patients are often restless, in some cases they may have pain, giving to the region of the heart and abdomen, similar to the manifestation of cardiovascular pathology. On examination with a slit lamp, corneal opacification due to edema is detected. The pupil is greatly dilated, the reaction to light is sharply weakened or absent. Palpation of the eyeball is hard as a stone.

All of the above symptoms of an acute attack of glaucoma require emergency medical care. If during the next hours after the development of the attack does not reduce the pressure with the help of drugs or surgically, the eye faces irretrievable loss of vision!

Diagnostics

The main problem in the diagnosis of glaucoma, first of all, open-angle, is the lack of typical symptoms in the early stages. Many people who have this disease are unaware of it. Therefore, it is very important, especially in old age, to be regularly examined by an ophthalmologist. There are several methods for the diagnosis of glaucoma.

Eye pressure is measured by the method of tonometry. Checking eye pressure is an important part of the diagnosis of glaucoma. High intraocular pressure is often the first sign of a disease. In some cases, anesthetic drops are buried in the eyes before the measurement. With the help of a special device - a tonometer - the pressure resistance of the cornea is measured. The intraocular pressure of 10 to 21 mm Hg is considered normal. (P0-true). However, in people with normotensive glaucoma, in which IOP is less than 21 mm Hg. Art., may be damage to the optic nerve and loss of visual fields.

Gonioscopy (inspection of the angle of the anterior chamber) allows you to get a clear idea of ??the state of the angle of the anterior chamber of the eye to determine the type of glaucoma. With a routine inspection this is difficult to do. Using a mirror lens makes it possible to inspect the angle of the anterior chamber and establish the presence of an open-angle (if the angle of the anterior chamber does not function effectively) or closed-angle (if the angle of the anterior chamber is at least partially closed) of glaucoma or a dangerous narrowing of the angle of the anterior chamber eyes that can block it).

Ophthalmoscopy (examination of the optic nerve head to detect signs of damage) is performed using an ophthalmoscope, a tool that allows you to examine the internal structure of the eye in magnification. The pupil while expanding with special drops. Glaucoma damages the optic nerve, causing the death of its constituent fibers. As a result, its appearance changes, it begins to resemble a bowl. If its size increases, dark spots appear in the field of view.

Perimetry reveals "dark" spots in the field of view. The test results will show their presence and localization. Some of them the patient may not even notice. The test is performed using a cup-shaped instrument called a perimeter. Only one eye can be checked at a time, so the second eye is covered with a bandage during the examination. The patient should look strictly straight at the mark. The computer sends a signal and luminous dots flash in the device in random order. The patient should press a button when he sees them. Not every beep is accompanied by a dot. Perimetry is usually performed every 6-12 months to monitor changes.

Pachymetry is the measurement of corneal thickness. This indicator may affect the accuracy of IOP measurement. If the cornea is very thick, then the intraocular pressure will actually be lower than according to the tonometry data. Conversely, with a very thin cornea, the true intraocular pressure is higher than the measurement result indicates.

Forms of glaucoma

There are several forms of glaucoma. The most common is primary open-angle glaucoma (POAG). Such forms of glaucoma, such as angle-closure, normotensive, congenital, pigment, secondary and others, are less common.

Primary open angle glaucoma

Chronic glaucoma, also known as primary open-angle glaucoma (POAG), is often called the "quiet thief of sight" because it is asymptomatic. The pressure in the eye slowly rises, and the cornea adapts to this without any protrusion. Therefore, most often the disease remains unnoticed. If there is no pain, then the patient usually does not even suspect that he slowly loses sight until the disease passes into a later stage. However, the vision gradually deteriorates and the damage becomes irreversible.

In open-angle glaucoma, an imbalance occurs between the product and the outflow of a clear liquid (aqueous humor) that is filtered through the anterior chamber of the eye. This can occur if the ciliary body produces a very large amount of this moisture or drainage channels (trabecular network) in the anterior chamber are blocked, which causes an increase in intraocular pressure.

As a result of an increase in IOP, pressure on the optic nerve fibers that transmit visual images to the brain increases. This leads to a deterioration of the blood supply, depriving the tissue of oxygen and nutrients. After some time, high pressure leads to irreversible damage to the optic nerve and loss of vision.

However, more than 2/3 of patients with elevated intraocular pressure (more than 21 mmHg) have no loss of visual fields or expansion and deepening of the excavation of the optic nerve head. This condition is called ophthalmic hypertension.

It is known that the factors of the development of open-angle glaucoma are injuries, uveitis, treatment with steroid drugs. While steroid therapy of any kind can increase intraocular pressure, local and parabulbar administration of steroids cause its increase to a greater degree.

POAG is a chronic disease that can be inherited. At the moment there is no treatment for this pathology, but the course can be slowed down or suspended. Due to the lack of symptoms, many patients find it difficult to understand the need for lifelong use of expensive drugs, especially when taking these drugs is burdensome and has a lot of side effects.

As with other forms of glaucoma, treatment includes antiglaucoma eye drops. Laser or other surgical treatment can also be recommended as a way to reduce IOP.

Regular intake of prescribed drugs is essential for the prevention of damage to the eyesight. Therefore, it is important for the patient to discuss side effects with the doctor in order to choose the most suitable drug for himself.

Angle-closure glaucoma

In the front of a healthy eye, a liquid (aqueous humor) forms and flows out of it, creating enough pressure to maintain the correct shape of the eye without damaging it. That is, the amount of intraocular fluid that constantly forms in the eye is balanced by the amount that just as constantly flows out of it through a certain place called the "anterior chamber angle".

This name he received due to the fact that in this place the iris is directly adjacent to the cornea. In fact, the implementation of the drainage function in the eye is possible at an angle of at least 30 degrees. If the angle is blocked, the fluid will continue to be produced at a normal rate, but will not be able to flow out of the eye, due to which the pressure reaches dangerous values. This is the mechanism for the development of one type of glaucoma, known as angle-closure (narrow-angle) glaucoma.

At an angle of 15 degrees, there remains a very small anterior chamber between the iris and the cornea and a small space between the iris and the Schlemm's canal.

The reasons for the abnormal location of the iris in glaucoma with a narrow angle can be the following:

pupil block
the intraocular fluid is produced by the ciliary body, which is located behind the iris. As a rule, it easily flows through the pupil into the anterior chamber of the eye. But if the lens is tightly attached to the back surface of the iris, this outflow is blocked. Then the fluid left behind the iris pushes it forward until the anterior chamber angle closes.
flat iris (Iris plateau syndrome)
in this state, the iris is attached to the ciliary body too close to the trabecular meshwork, which participates in the outflow of aqueous humor. When the pupil expands, the resulting folds of the peripheral part of the iris in the corner of the anterior chamber can close this network, causing a rapid increase in IOP. This type of aggravation of narrow-angle glaucoma may be caused by excessive dilation of the pupil due to various reasons.
narrow angle of the front camera
when the length of the eye is less than the norm (which is the cause of hyperopia), the anterior chamber is shallow and, accordingly, its angle is also less than the norm. This increases the risk of closed angle glaucoma with dilated pupil or with age-related changes.
tumors and other causes
a tumor located behind the iris, swelling associated with inflammation of the ciliary body (uveitis), and changes in the shape of the eye after surgery for retinal detachment can also cause angle-closure glaucoma.

Treatment of angle-closure glaucoma

The goal of treatment is to reduce intraocular pressure as quickly as possible. This can be achieved by using systemic drugs orally and sometimes intravenously. For topical treatment of this pathology, antiglaucoma eye drops are also used. Often, laser and / or surgical treatments may be required to reduce intraocular pressure.

An acute attack of glaucoma is accompanied by the appearance of symptoms such as eye pain, headache, appearance of halos around light sources, pupil dilation, reduced vision, redness of the eyes, nausea and vomiting. These manifestations can last for an hour or until IOP is reduced. With each such glaucoma attack, some of the peripheral vision may be lost.

An acute attack of glaucoma requires emergency medical care. If the drainage angle of the eye is not opened in order to remove excess amount of aqueous humor, and the pressure in the eye does not decrease within a few hours, it can damage the optic nerve and loss of vision. Therefore, when these symptoms appear, you should immediately contact an ophthalmologist or the hospital emergency room.

Remember that an acute attack of angle-closure glaucoma may be caused by dilation of the pupil, as a result of which the iris blocks the draining angle of the anterior chamber of the eye. Other factors include dim lighting, eye drops used to examine the fundus of the eye, and eye forms of certain medications, such as antihistamine / sympathomimetic drugs, as well as chilled medications.

Congenital glaucoma

Children's glaucoma is a rare eye disease that is one of the main causes of blindness in children. Its occurrence is associated with an anomalous increase in intraocular pressure.

Glaucoma, which appears immediately after birth or in the first year of a child's life, is called infantile. With a later manifestation of glaucoma, it is called infant.

Primary congenital glaucoma is the result of improper development of the drainage system of the eye. It occurs in about 1 in 10,000 newborns and is the most common form of glaucoma in children. Secondary glaucoma occurs due to abnormalities in the body or in the eye; it can be genetically determined or acquired. Both types can be combined with other diseases.

About 10 percent of cases of primary congenital glaucoma are detected at birth, and 80 percent are diagnosed during the first year of life. Primarily a pediatrician or parents notice glaucoma eye symptoms, including clouding and / or corneal enlargement.

Increased intraocular pressure can lead to an increase in the eyeball (which at first gives the impression of large, beautiful eyes) and damage to the cornea. The most important early symptoms of glaucoma in children are poor vision, increased sensitivity to light, tearing, frequent blinking.

Congenital glaucoma in the overwhelming number of cases (75%) develops in both eyes. However, the degree of development of the pathological process, as a rule, is not the same.

Treatment of childhood glaucoma is different from that of adults. Most patients require surgical intervention, which is usually performed as early as possible. The goal of pediatric glaucoma surgery is to reduce intraocular pressure by increasing the outflow of intraocular fluid or reducing its production inside the eye. One of the methods in this case is goniotomy. The probability of success of this operation is directly related to the age of the child at the time of diagnosis, the type and severity of glaucoma, as well as the surgical technique of the operator. Other surgical interventions are trabeculectomy and bypass surgery.

Approximately 80-90 percent of children who received surgical treatment in a timely manner, had constant care, as well as the specialist's observation of the development of their visual functions, have good chances for normal or almost normal vision in the future. Unfortunately, primary congenital glaucoma leads to blindness in 2-15 percent of children. If it was not recognized and the treatment was not started in time, the result would be irreversible loss of vision.

Normotensive glaucoma

Normotensive glaucoma (NTG), also known as low pressure glaucoma or normal pressure glaucoma, is a form of glaucoma when damage to the optic nerve occurs at intraocular pressure not exceeding normal values. The angle of the anterior chamber in this pathology is open, as in the case of the most common open-angle glaucoma. Indices of intraocular pressure are in the normal range - 10-21 mm Hg. st. (true IOP). The average age of patients with normotensive glaucoma is 60 years.

The causes of the development of normotensive glaucoma are still not known. It is likely that in some patients there is a genetic predisposition to damage the optic nerve even with normal eye pressure. An important role is played by vascular factors, such as vasospasm and ischemia. Scientists are continuing research to find out the reasons for this.

More others at risk:

having a family history of normotensive glaucoma;
descendants of immigrants from Japan and Korea;
women versus men;
suffering from systemic heart disease, such as, for example, a heart rhythm disorder.

The presence of normotensive glaucoma is established by examining the optic nerve for signs of damage. This can be done in two ways.

The first is to use a tool called an ophthalmoscope. In a darkened room, the ophthalmoscope is brought closer to the eye, and the light beam enables the doctor to examine the shape and color of the optic nerve disk (OND) through the pupil. The presence of his pathological excavation or the absence of normal pink color will cause alertness.

The second method is perimetry. He gives information about changes in the field of view of the patient. Using this test, the doctor identifies various areas of visual field loss that can be caused by damage to the optic nerve. Usually it looks like small changes in the interval from the zone close to the center to the edge of the field of view. They are not always found in the patient.

Differential diagnosis of normotensive glaucoma is performed with other types of glaucoma.

Various forms of glaucoma with a periodic increase in IOP can simulate NTG. These include angle-closure glaucoma, in which the damage to the optic disc is maintained for many years after the episode of increased IOP; primary open-angle glaucoma (POAG) with diurnal fluctuations of IOP; pigmentary glaucoma, in which exercise or other activity can cause a temporary increase in IOP, not detected during routine examination. Patients with POAG who have undergone refractive surgery have a thinner cornea, for which reason the IOP figures will be underestimated, which may erroneously suspect normotensive glaucoma.

In addition, the differential diagnosis of normotensive glaucoma is carried out with other diseases of the optic nerve, which, in turn, are not associated with increased IOP. These include ischemic optic neuropathy, Leber's hereditary optic neuropathy, drusen and the optic nerve fossa fossa, compression damage to the optic nerve. It is also necessary to exclude systemic diseases (syphilis, tuberculosis, sarcoidosis, multiple sclerosis) and the systemic effect of some drugs. For example, the anti-TB drugs ethambutol and isoniazid can damage the optic nerve and cause optic neuropathy in patients with normal IOP.

Because so little is known about why, in some cases, with normal eye pressure, eye damage occurs, most doctors treat normotensive glaucoma, reducing intraocular pressure as much as possible. The target in most cases is the pressure (P0) of 8-15 mm Hg. Art. Drug therapy can be used for this. Its effectiveness may indicate a decrease in IOP of 30% compared with its initial level. At the same time, administration of drugs with a potential vasoconstrictor or systemic antihypertensive effect should be avoided. Studies are being conducted on the use of oral calcium channel blockers in the treatment of this form of glaucoma. Laser trabeculoplasty is rarely used, since the outflow of IOP is not difficult. Surgical treatment may be necessary if the above techniques fail to achieve the target pressure. However, this method is associated with an increased risk of postoperative hypotension and endophthalmitis.

In the case of establishing the diagnosis of normotensive glaucoma, it is necessary to regularly monitor an ophthalmologist 2 times a year.

Rare types of glaucoma

The most common type of glaucoma is open-angle. Less common are its types such as angle-closure and normotensive glaucoma. Even more rare, but, nevertheless, represent a serious threat to the eyes and other types of this disease, which we consider in this article.

Pigment glaucoma

Pigmented glaucoma is a type of open-angle glaucoma that is inherited and develops more often in men than in women. Most often, the development of the disease begins at the age of 20-30, which makes it especially dangerous for normal vision. Usually this type of glaucoma occurs in patients with myopia. The anatomical features of the eye structure of these patients play a key role in the development of this pathology. The reason is that myopic (myopic) eyes have a concave-shaped iris, which forms an unusually wide angle. As a result, the pigment layer rubs against the lens, which causes the pigment of the iris to fall and get into the aqueous humor and on neighboring structures, such as the trabecular network. The pigment can clog its pores, causing clogging, which in turn leads to an increase in IOP.

The use of drugs that cause constriction of the pupils (miosis) is recommended, but these drugs in the form of drops can lead to a decrease in the clarity of vision of patients. Fortunately, there are dosage forms with a long period of action. The effectiveness of laser iridotomy in the treatment of this pathology is currently being investigated.

Secondary glaucoma

Secondary glaucoma develops in cases where another disease causes or contributes to an increase in intraocular pressure, as a result of which the optic nerve is damaged and vision is lost.

Secondary glaucoma may occur as a result of an eye injury, inflammation, swelling, in far-gone cases of cataract or diabetes. It can also be caused by taking certain medications, such as steroids. This form of glaucoma can be mild or severe. The type of treatment will depend on whether open-angle or closed-angle secondary glaucoma.

Pseudoexfoliative glaucoma

This form of secondary open-angle glaucoma occurs when pieces of tissue in the form of scales, similar to dandruff, peel from the outer surface of the lens. They collect in the corner between the cornea and the iris and can clog the drainage system of the eye, causing an increase in intraocular pressure. This form of glaucoma is often accompanied by cataracts. Pseudoexfoliative glaucoma is common among Scandinavians. Treatment usually involves medication or surgery.

Traumatic glaucoma

Damage to the eye (both its dull injury and penetrating injury) can lead to the development of secondary open-angle glaucoma. Conditions such as severe myopia, previous injuries, infections, or history of operations can make the eyes more vulnerable to serious damage. In such cases, glaucoma may occur not only immediately after the injury, but even after several years.

Iridocorneal endothelial syndrome

Iridocorneal endothelial syndrome (ICE syndrome) - includes three types of pathologies: iris nevus (Kogan-Riza syndrome), Chandler syndrome and progressive iris atrophy. In most cases, the disease is unilateral, most often women aged 30-50 suffer. In its pathogenesis lies the overgrowth of atypical endothelial cells of the cornea and the Descemet's membrane of the anterior chamber angle and the iris. This leads to a deterioration of the drainage function and, as a consequence, increased IOP and the development of dystrophic glaucoma, as well as deterioration of the nutrition of the surrounding tissues and their atrophy. The cause of the disease is currently not established, however, in patients in most cases, the examination reveals the herpes simplex virus. Drug treatment is often ineffective. In most cases, filtering operations are required.

Neovascular glaucoma

The formation of abnormal blood vessels in the iris and in the area of ??the drainage channels can lead to the development of secondary (neovascular) glaucoma.

The basis of this process most often is retinal ischemia, which stimulates the production of vascular endothelial growth factor (VEGF), which causes the growth of abnormal vessels. They in turn block the outflow of eye fluid through the trabecular meshwork, causing an increase in intraocular pressure. Neovascular glaucoma is always associated with other disorders in the body. Its most common causes are:

proliferative diabetic retinopathy;
occlusion of the central retinal vein;
carotid artery occlusion.

Depending on the severity of neovascularization, this form of glaucoma is divided into 3 stages:

rubeosis of the iris;
secondary open-angle glaucoma;
secondary synechial angle-closure glaucoma.

Neovascular glaucoma is difficult to treat. First of all it is necessary:

determine the etiological factor;
in case of detection of diabetic retinopathy, occlusion of the carotid artery, central vein or retinal artery - promptly carry out appropriate treatment;
treatment should correspond to the stage of the disease.

For the treatment of neovascular glaucoma, the following methods are used:

drug therapy (atropine 1%, topical steroids, carbanhydrase inhibitors, beta blockers, parenteral and oral osmotic agents (mannitol, glycerol));
panretinal photocoagulation or cryocoagulation;
goniofotokoagulyatsiya;
njections of vascular endothelial growth factor inhibitors;
cyclo photocoagulation;
trabeculectomy with mitomycin C and filtering surgery;
retrobulbar alcoholization or enucleation in case of uncropped pain syndrome.

Treatment methods

Eye drops, tablets, laser surgery, conventional surgery, or a combination of these methods are used to treat glaucoma. Their purpose - to prevent the loss of vision, irretrievable with glaucoma. The main objective of treatment is to reduce IOP to an acceptable level, which is achieved in two ways: reducing the production of intraocular fluid and improving the outflow of fluid. Optimism is suggested by the fact that the course of glaucoma can be controlled by its early detection, and due to conservative and / or surgical treatment, most patients with glaucoma do not lose the ability to see.

Tactics of treatment of glaucoma depends on its type, cause of development, severity of the course of the disease.

Drug treatment of glaucoma

Eye drops are the most common treatment for glaucoma. They reduce intraocular pressure in two ways - reducing the production of aqueous humor or improving its outflow through the anterior chamber angle.

Drops should be instilled daily. Like any other medication, it is important to take them regularly, as prescribed by an ophthalmologist. Never change or stop taking your medication without consulting your doctor. If for some reason you are going to interrupt its use, check with your doctor about how you can replace it.

Glaucoma Surgery

Some patients with glaucoma have been treated with a surgical treatment that improves the flow of intraocular fluid, thereby reducing eye pressure.

Laser trabeculoplasty. This surgery is often used in open-angle glaucoma. There are two types of trabeculoplasty: argon-laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT).

During ALT, the laser makes thin, evenly distributed burns in the trabecular meshwork. It does not create new drainage holes, but stimulates more efficient operation of the outflow system.

In SLT, a laser is used at different frequencies, allowing operation at low power levels. At the same time, there is an impact on a certain type of cells, and the filtering channels, like the network surrounding the iris, remain intact. SLT can give a result in those patients whose treatment with conventional laser surgery or eye drops was unsuccessful.

Even if laser trabeculoplasty was successful, most patients continue to take drugs. For them, this method does not give a long-term effect. Approximately half of those who underwent this intervention, within 5 years, again increased intraocular pressure. Many patients who have undergone successful laser trabeculoplasty are forced to re-go through it.

Laser trabeculoplasty can also be used as a primary method in those patients who do not want or can not use anti-hypertensive eye drops.

Laser iridotomy. Laser iridotomy is indicated for the treatment of patients with angle-closure glaucoma or a very narrow anterior chamber angle. The laser makes a small hole the size of a pinhead at the top of the iris and thus improves the flow of aqueous humor through the anterior chamber angle. This hole is hidden by the upper eyelid, so that it is not outwardly visible.

Peripheral iridectomy. When laser iridotomy is not able to stop an acute attack of angle-closure glaucoma or is not possible for other reasons, peripheral iridectomy can be performed. A small portion of the iris is removed, giving intraocular fluid access to the drainage system of the eye. Due to the fact that most cases of angle-closure glaucoma can be cured by taking glaucoma drugs and laser iridotomy, peripheral iridectomy is used quite rarely.

Trabeculectomy. With trabeculectomy, a small valve is formed from the sclera (white tissue covering the eye). The filtering pad, or reservoir, is created under the conjunctiva - a thin tissue covering the sclera. Once formed, the pad looks like a bulge or blister on the white part of the eye above the iris, usually hidden by the upper eyelid. As a result, the watery moisture can be drained through a valve created in the sclera and collected in the pad from where it will be absorbed by the blood vessels of the eyeball.

Eye pressure is effectively reduced in 3 of 4 patients undergoing trabeculectomy. Despite the fact that regular examinations by an ophthalmologist are necessary, most patients for a long time do not need to use eye drops. If the newly formed filter channel closes or too much fluid begins to flow from the eye, additional surgical intervention is necessary.

Surgical interventions with the use of drainage devices (shunt surgery).

If trabeculectomy cannot be performed, surgeries using drainage devices are usually successful to reduce intraocular pressure.

A shunt is a small plastic tube or valve connected at one end to a reservoir (round or oval plate). It is an artificial drainage device implanted into the eye through a thin incision. When the IOP rises above certain numbers, the shunt redirects the aqueous humor into the sub-tenon space (under the tenon capsule covering the eyeball outside the palpebral fissure), from where it is absorbed into the bloodstream. When everything is healed, the reservoir can be seen only if, when looking down, you lift the eyelid.

Folk remedies in the treatment of glaucoma

On the Internet you can find many recipes for treating glaucoma with broths and tinctures of herbs, vitamins, various lotions, etc. Ophthalmologists are not by chance extremely negative about such tips. Practice has not confirmed the effectiveness of folk remedies in the treatment of glaucoma. Hope for them will only delay the visit to the doctor and the timely start of proper treatment. Meanwhile, the disease will progress, which will result in an increase in the degree of irretrievable loss of vision.

Risk factors for the development of glaucoma

Risk factors are causes that increase the likelihood of developing a disease. However, glaucoma can be detected with or without the factors described below. However, the more they are present, the higher the risk of developing this pathology. If you notice any of these factors, tell your health care provider. This will help reduce the risk of developing pathology.

Risk factors for the development of glaucoma include:

The presence of glaucoma in close relatives
This disease can be inherited. However, if someone from your relatives suffers from glaucoma, this does not mean that the disease will definitely develop in you.
Race
In black people, open-angle glaucoma occupies a leading place among the causes of blindness and is found 6-9 times more often than among the population with white skin. It should be added that the risk of developing pathology in blacks increases after 40 years. Eskimos and Asians are less at risk.
Age
According to the American Academy of Ophthalmology, the risk of developing glaucoma increases after 50 years.
High intraocular pressure
People with increased intraocular pressure have a higher risk of developing glaucoma. Increased intraocular pressure is more than 21 mm Hg. st. (P0 - true).
Thin cornea
Recent large clinical studies have shown that patients with thinner corneas have a greater risk of developing glaucoma. It was also found that the thickness of the cornea of African Americans is less than that of fair-skinned people.
Refractive errors
The presence of myopia leads to an increased risk of developing open-angle glaucoma, and farsightedness - closed-angle.
Regular long-term steroid / cortisone use
Prolonged use of all forms of corticosteroids increases the risk of disease
History of injuries and eye surgeries
Injuries can damage the structure of the eye, which is accompanied by a deterioration of the outflow of intraocular fluid. Complications of eye surgery can also lead to the development of glaucoma.

In addition to the above risk factors for the development of glaucoma, in some studies they indicate such causes as high blood pressure, obesity, cardiovascular diseases and diabetes. However, there is not enough convincing evidence to support this view.

In itself, the presence of one or even several risk factors does not mean that you will inevitably develop glaucoma. However, in conjunction with the symptoms of this disease, this is a reason to consult a doctor as soon as possible. In addition, even in the absence of symptoms, it is advisable to regularly (once a year) visit an ophthalmologist for a routine examination.