Glaucoma

glaucomaGlaucoma is a disease of the eye, the main feature of which is the increase in intraocular pressure. Distinguish primary and secondary glaucoma. The etiology of primary glaucoma is not clear. Secondary glaucoma may develop as a complication of a number of eye diseases (iridotsyklit, intraocular tumors and other).
There are two clinical forms of primary glaucoma: stagnant and simple. When glaucoma periodically, the pain in the eyes, blurred vision, a vision of a bright circles around the light when seen detected changes in the anterior eyes, blood vessels, some swelling of the cornea, pupil dilation. Simple glaucoma long time asymptomatic and discovered upon examination by a decrease in visual acuity, narrowing of the field of view.
On stage of the process gets, developed, advanced, almost total and absolute glaucoma. When primary glaucoma visual acuity and visual field is not changed. Developed glaucoma is characterized by a narrowing of the field of view by 15-20 degrees; when far advanced glaucoma there is a more significant narrowing of the field of view is usually from the nasal side. Almost absolute glaucoma is characterized by low vision, and it is stored only with temporal hand, with absolute glaucoma is not even light sensation. The deterioration of visual functions in glaucoma is associated with atrophic changes in the optic nerve.
There are four degrees of compensation intraocular pressure in glaucoma: compensation-intraocular pressure does not exceed 28 mm RT. Art. (norm - from 18 to 27 mm RT. century), subcompensated - from 29 to 35 mm RT. Art., decompensate - above 35 mm RT. Art. and decompensation, or acute glaucoma attack, in which the intraocular pressure may rise to 70-80 mm RT. Art.
For primary glaucoma diverse. It usually develops gradually. Acute attack (decompensation) glaucoma occurs infrequently accompanied by acute pain in the eye and surrounding areas (the head, the forehead), the deterioration of the General condition. Often there are nausea and vomiting. The eyeball hyperemic, the pupil is wide, visual acuity is sharply reduced.
The chronic course of glaucoma to save the view is set to early diagnosis and timely treatment. When intraocular pressure equal 27-28 mm RT. Art., you must complete the glaucoma screening is a doctor-ophthalmologist).
Forecast for glaucoma always serious, and preservation of view often depends on the timeliness of diagnosis, adherence and care treatment.
Treatment of glaucoma holds a doctor-ophthalmologist. Destination it can perform the nurses. Acute attack of glaucoma required frequent putting in a bad eye mitotic (convergent pupil) funds (2% solution pilokarpina and others), the appointment of the interior diakarba (favourite) 0.5-0.25 g or glycerol (a mixture of equal amounts of glycerin and isotonic solution of sodium chloride at the rate of 1 to 1.5 grams of glycerin per 1 kg of body weight of the patient, leeches on the temple, hot foot bath, saline laxative. If the attack is not stopped, need urgent antiglaucomatous operation (the patient should be sent to a specialist hospital).
Chronic glaucoma appoint instillation in kongungualny bag mioticescimi means: 1, 2, and 6% solution pilokarpina, 0.25% solution of ezerin, 0.5% solution prozerina (1-2 drops 1-6 times a day), 0.02% solution of postagola, 0.005% solution Armin (1 to 2 drops 2 times a day) and other Inside appoint diakarb (Favorit) 0,125-0,25 g, 2-3 times a day. Use a variety of vitamins (B1, B2, B6, B12, C, PP) and other tools.
Indications for surgery for glaucoma is steadfastly increased inner pressure from progressing loss of visual functions, especially the narrowing of the field of view, despite conservative treatment. The most widely pistoleiros operations. As a result of these operations is created artificial way of intraocular fluid from the anterior chamber of the eye. After pistoleiros operations on the place of the cut of the sclera is formed elation of the conjunctiva, the so - called filtration pillow. On the operated eye dressings. Bed rest during 1-2 days.
Glaucoma patients should follow a specific mode. The necessary fluid restriction prior to 5 cups a day, the regulation of the activity of the intestines, improving sleep. Excluded strong tea, organic coffee and alcoholic drinks. Contraindicated drugs belladonna and caffeine. Avoid prolonged stay in the dark. Reading and other visual work is valid. It is recommended that the use of sunglasses with green glass. Employment includes a number of activities that facilitate the work of the patients with glaucoma: work in the daytime and in the light room, interruptions; should avoid nervous and physical strain, fatigue and etc.
Glaucoma most part begins and often goes unnoticed. When the complaint patients, especially the elderly, on reduction of vision, pain in the eyes of the medical officer shall direct them to the doctor-ophthalmologist. The most effective in the conservation of view is dispensary method of service to patients with glaucoma, providing for active revealing of people suspected glaucoma, systematic monitoring, early detection of glaucoma, timely and correct treatment.


Fig. 3. Glaucoma excavation and atrophy of the optic nerve papilla.
Fig. 4. Normal eye bottom: 1 - uniform color fundus of the eye; 2 - the parquet of the eye; 3 - the fundus of the eye with a small amount of pigment.
Fig. 5. Separation of the optic nerve. Fig. 6. Multiple breaks the choroid.