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Glaucoma: Causes, Types, Symptoms, Diagnosis and Treatment

What is Glaucoma?

Glaucoma is a condition that damages your eye's optic nerve. It can get worse over time, and it is often linked to a build-up of pressure inside your eye. Glaucoma tends to run in families. You usually don't get it until later in life.

If your intraocular pressure (the pressure inside your eyes) rises too high, it can damage your optic nerve, which sends images to your brain. If the damage gets worse, glaucoma can cause permanent vision loss or even blindness within a few years.

If you are diagnosed with glaucoma, you may not experience any early symptoms. Make sure to see your eye doctor on a regular basis so they can diagnose and treat the condition before you experience long-term vision loss.

If you lose vision, it cannot be regained. However, by lowering eye pressure, you may be able to keep the vision you have. Most people with glaucoma who follow their treatment plan and have regular eye exams are able to keep their vision.


What is Glaucoma



Explanation of medical terms and concepts Glaucoma


Glaucoma may be a cluster of eye conditions that injure the nervus opticus, the health of which is significant permanent vision. This injury is usually caused by AN abnormally air mass in your eye.

Glaucoma is one in every of the leading causes of visual impairment for individuals over the age of sixty. It will occur at any age however is a lot common in older adults.

Many styles of eye disease don't have any warning signs. The result is thus gradual that you simply might not notice an amendment in vision till the condition is at a sophisticated stage.

Because vision loss thanks to eye disease cannot be recovered, it is vital to possess regular eye exams that embody measurements of your eye pressure thus a diagnosis may be created in its early stages and treated fittingly. If eye disease is recognized early, vision loss may be slowed or prevented. If you've got the condition, you will usually want treatment for the remainder of your life.

There are several stages of glaucoma Glaucoma is a disease in which the optic nerve becomes damaged and vision loss occurs The following provides a general overview of each stage of glaucoma: Proliferative Stages – In these stages fluid pressure builds up inside the eye and damages the optic disk and causes permanent damage to vision This is the most common form of glaucoma and can occur at any age If this type of glaucoma is detected early treatment may prevent further progression or get it under control so there's no noticeable effect on vision.

Symptoms Glaucoma

The signs and symptoms of glaucoma vary depending on the type and stage of your condition. For example:

Open-angle glaucoma

  • Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes

  • Tunnel vision in the advanced stages

Acute angle-closure glaucoma

  • Severe headache

  • Eye pain

  • Nausea and vomiting

  • Blurred vision

  • Halos around lights

  • Eye redness

If left untreated, eye disease can eventually cause visual disorder. Even with treatment, fifteen p.c of individuals with eye disease become blind in a minimum of one eye at intervals twenty years.

When to see a doctor

Promptly head to an associate degree ER or an eye fixed doctor's (ophthalmologist's) workplace if you experience a number of the symptoms of acute glaucoma, like severe headache, eye pain and blurred vision. 

Causes Glaucoma

Glaucoma is the result of injury to the optic tract. As this nerve bit by bit deteriorates, blind spots develop in your visual view. For reasons that doctors do not absolutely perceive, this nerve injury is typically associated with enhanced pressure within the eye.

Elevated eye pressure is because of a buildup of a fluid (aqueous humor) that flows throughout the within of your eye. This internal fluid unremarkably drains out through a tissue known as the fibrous tissue fabric at the angle wherever the iris and tissue layer meet. Once fluid is overproduced or the system does not work properly, the fluid cannot effuse at its traditional rate and eye pressure will increase.

Glaucoma tends to run in families. In some individuals, scientists have known genes associated with high eye pressure and optic tract injury.

Types of glaucoma include:

Open-angle glaucoma

Open-angle glaucoma is the most typical sort of sickness. The drain angle fashioned by the membrane and iris remains open, however the fibrous tissue textile is partly blocked. This causes pressure within the eye to increase bit by bit. This pressure damages the second cranial nerve. It happens thus slowly that you just might lose vision before you are even responsive to a tangle.

Angle-closure glaucoma

Angle-closure eye disease, additionally known as closed-angle eye disease, happens once the iris bulges forward to slender or block the emptying angle fashioned by the tissue layer and iris. As a result, fluid cannot flow through the attention and pressure will increase. Some individuals have slender emptying angles, swinging them at inflated risk of acute glaucoma.

Angle-closure glaucoma could occur suddenly (acute angle-closure glaucoma) or step by step (chronic angle-closure glaucoma). Acute acute glaucoma could be a medical emergency.

Normal-tension glaucoma

In normal-tension eye disease, your second cranial nerve becomes broken albeit your eye pressure is at intervals the conventional vary. Nobody is aware of the precise reason for this. you'll have a sensitive second cranial nerve, otherwise you could have less blood being equipped to your second cranial nerve. This restricted blood flow may well be caused by coronary artery disease — the buildup of fatty deposits (plaque) within the arteries — or different conditions that impair circulation.

Glaucoma in children

It's doable for infants and kids to have eye disease. it should be a gift from birth or develop within the 1st few years of life. The cranial nerve harm is also caused by emptying blockages or Associate in Nursing underlying medical conditions.

Pigmentary glaucoma

In pigmentary eye disease, pigment granules from your iris build up within the emptying channels, speed or obstruction fluid exiting your eye. Activities like cardiopulmonary exercise typically kindle the pigment granules, depositing them on the trabecular mesh and inflicting intermittent pressure elevations.

Risk factors Glaucoma

Because chronic forms of glaucoma can destroy vision before any signs or symptoms are apparent, be aware of these risk factors:

  • Having high internal eye pressure (intraocular pressure)

  • Being over age 60

  • Being black, Asian or Hispanic

  • Having a family history of glaucoma

  • Having certain medical conditions, such as diabetes, heart disease, high blood pressure and sickle cell anemia

  • Having corneas that are thin in the center

  • Being extremely nearsighted or farsighted

  • Having had an eye injury or certain types of eye surgery

  • Taking corticosteroid medications, especially eye drops, for a long time

Prevention

These self-care steps can help you detect glaucoma in its early stages, which is important in preventing vision loss or slowing its progress.

  • Get regular dilated eye examinations. Regular comprehensive eye exams will facilitate eye disease in its early stages, before vital harm happens. As a general rule, the yank Academy of medical specialty recommends having a comprehensive eye communication each 5 to ten years if you are beneath forty years old; each 2 to four years if you are forty to fifty four years old; all to 3 years if you are fifty five to sixty four years old; and each one to 2 years if you are older than sixty five. If you are in danger of eye disease, you'll have a lot of frequent screening. raise your doctor to advocate the proper screening schedule for you. 

  • Know your family's eye health history. Glaucoma tends to run in families. If you are at exaggerated risk, you would like a lot of frequent screening.
    Exercise safely. Regular, moderate exercise might help stop eye disease by reducing eye pressure. speak along with your doctor regarding an associate degree applicable exercise program. 

  • Take prescribed eye drops regularly. Glaucoma eye drops will considerably cut back the chance that prime eye pressure can make eye disease. To be effective, eye drops prescribed by your doctor have to be used frequently although you have no symptoms. 

  • Wear eye protection. Serious eye injuries can lead to glaucoma. Wear eye protection when using power tools or playing high-speed racket sports in enclosed courts.

Diagnosis Glaucoma

Your doctor will review your medical history and conduct a comprehensive eye examination. He or she may perform several tests, including:

  • Measuring intraocular pressure (tonometry)

  • Testing for optic nerve damage with a dilated eye examination and imaging tests

  • Checking for areas of vision loss (visual field test)

  • Measuring corneal thickness (pachymetry)

  • Inspecting the drainage angle (gonioscopy)

Treatment Glaucoma

The harm caused by eye disease cannot be reversed. However treatment and regular checkups will facilitate slow or forestall vision loss, particularly if you catch the malady in its early stages.

Glaucoma is treated by lowering your eye pressure (intraocular pressure). counting on your state of affairs, your choices might embrace prescription eye drops, oral medications, optical maser treatment, surgery or a mix of any of those.

Eyedrops

Glaucoma treatment typically starts with prescription eye drops. These will facilitate decrease eye pressure by rising however fluid drains from your eye or by decreasing the number of fluid your eye makes. counting on however low your eye pressure has to be, over one amongst the eye drops below may have to be prescribed.

 

Prescription eye-drop medications include:

  • Prostaglandins. These increase the outflow of the fluid in your eye (aqueous humor), thereby reducing your eye pressure. Medicines during this class embrace latanoprost (Xalatan), travoprost (Travatan Z), tafluprost (Zioptan), bimatoprost (Lumigan) and latanoprostene bunod (Vyzulta).
    Possible facet effects embrace delicate reddening and stinging of the eyes, darkening of the iris, darkening of the pigment of the eyelashes or palpebra skin, and blurred vision. This category of drug is prescribed for once-a-day use. 

  • Beta blockers. These cut back the assembly of fluid in your eye, thereby lowering the pressure in your eye (intraocular pressure). Examples embody beta-adrenergic blocker (Betimol, Istalol, Timoptic) and betaxolol (Betoptic).
    Possible aspect effects embody issue respiration, slowed pulse, lower pressure level, impotence and fatigue. This category of drug is often prescribed for once- or twice-daily use betting on your condition. 

  • Alpha-adrenergic agonists. These cut back the assembly of liquid body substance and increase outflow of the fluid in your eye. Examples embrace apraclonidine (Iopidine) and brimonidine (Alphagan P, Qoliana).
    Possible aspect effects embrace AN irregular rate, high vital sign, fatigue, red, restless or swollen eyes, and dryness. This category of drug is {sometimes} prescribed for twice-daily use however sometimes will be prescribed to be used thrice daily. 

  • Carbonic anhydrase inhibitors. These medicines scale back the assembly of fluid in your eye. Examples embrace dorzolamide (Trusopt) and brinzolamide (Azopt). attainable facet effects embrace a argentiferous style, frequent excreting, and tingling within the fingers and toes. This category of drug is {sometimes} prescribed for twice-daily use however sometimes will be prescribed to be used 3 times every day. 

  • Rho kinase inhibitor. This medicine lowers eye pressure by suppressing the rho kinase enzymes responsible for fluid increase. It is available as netarsudil (Rhopressa) and is prescribed for once-a-day use. Possible side effects include eye redness, eye discomfort and deposits forming on the cornea.

  • Miotic or cholinergic agents. These increase the outflow of fluid from your eye. An associate example is alkaloid (Isopto Carpine). aspect effects embrace headache, eye ache, smaller pupils, doable blurred or dim vision, and myopia. This category of medication is typically prescribed to be burnt up to fourfold on a daily basis. Thanks to potential side effects and also the would like for frequent daily use, these medications don't seem to be prescribed fairly often any longer.
    Because a number of the driblet drugs are absorbed into your blood, you will experience some side effects unrelated to your eyes. to attenuate this absorption, shut your eyes for one to 2 minutes when swing the drops in. you will additionally press gently at the corner of your eyes close to your nose to shut the channel for one or 2 minutes. Wipe off any unused drops from your protective fold.
    If you have been prescribed multiple eyedrops otherwise you have to be compelled to use artificial tears, house them out in order that you're waiting a minimum of 5 minutes in between sorts of drops. 

Oral medications

If eye drops alone do not bring your eye pressure all the way down to the specified level, your doctor might also order associate oral medication, sometimes an element of anhydrase substance. attainable facet effects embody frequent excreting, tingling within the fingers and toes, depression, upset stomach, and excretory organ stones.

Surgery and other therapies

Other treatment options include laser therapy and various surgical procedures. The following techniques are intended to improve the drainage of fluid within the eye, thereby lowering pressure:

  • Laser therapy. Laser trabeculoplasty (truth-BEK-u-low-plas-tee) is an associate degree choice if you have got glaucoma. It's wiped out your doctor's workplace. Your doctor uses atiny low ray of light to open clogged channels within the trabecular cloth. It should take many weeks before the total impact of this procedure becomes apparent. 

  • Filtering surgery. With a surgery referred to as a trabeculectomy (truth-bek-u-LIKE-tuh-me), your operating surgeon creates a gap within the white of the attention (sclera) and removes a part of the fibrous tissue mesh. 

  • Drainage tubes. In this procedure, your eye surgeon inserts a small tube shunt in your eye to drain away excess fluid to lower your eye pressure.

  • Minimally invasive glaucoma surgery (MIGS). Your doctor might recommend a MIGS procedure to lower your eye pressure. These procedures usually need less immediate surgical care and have less risk than trabeculectomy or putting in a evacuation device. they're typically combined with cataract surgery. There are a variety of MIGS techniques on the market, and your doctor can discuss which procedure could also be right for you.
    After your procedure, you will need to envision your doctor for follow-up exams. And you will eventually have to be compelled to bear further procedures if your eye pressure begins to rise or different changes occur in your eye. 

Treating acute angle-closure glaucoma

Acute glaucoma may be a medical emergency. If you are diagnosed with this condition, you'll have imperative treatment to cut back the pressure in your eye. This usually would force each medication and optical maser or alternative surgical procedures.

You may have a procedure known as an optical maser peripheral surgical procedure within which the doctor creates a little gap in your iris employing an optical maser. This permits fluid (aqueous humor) to flow through it, relieving eye pressure. 

Lifestyle and home remedies

These tips may help you control high eye pressure or promote eye health.

  • Eat a healthy diet. Eating a healthy diet can help you maintain your health, but it won't prevent glaucoma from worsening. Several vitamins and nutrients are important to eye health, including zinc, copper, selenium, and antioxidant vitamins C, E, and A.

  • Exercise safely. Regular exercise may reduce eye pressure in open-angle glaucoma. Talk to your doctor about an appropriate exercise program.

  • Limit your caffeine. Drinking beverages with large amounts of caffeine may increase your eye pressure.

  • Sip fluids frequently. Drink solely moderate amounts of fluids at any given time throughout the course of a daily basis. Drinking a quart or additional of any liquid inside a brief time might quickly increase eye pressure. 

  • Sleep with your head elevated. Using a wedge pillow that keeps your head slightly raised, about 20 degrees, has been shown to reduce intraocular pressure while you sleep.

  • Take prescribed medicine. Using your eyedrops or different medications as prescribed will assist you get the simplest potential result from your treatment. make sure to use the drops specifically as prescribed. Otherwise, your second cranial nerve harm might worsen. 

Alternative medicine

Some alternative medicine approaches may help your overall health, but none is an effective glaucoma remedy. Talk with your doctor about their possible benefits and risks.

  • Herbal remedies. Some flavoring supplements, like bilberry extract, are publicized as eye disease remedies. however additional study is required to prove their effectiveness. do not use flavoring supplements in situ of tried therapies. 

  • Relaxation techniques. Stress could trigger an Associate in Nursing attack of acute glaucoma. If you are in danger of this condition, realize healthy ways in which to address stress. Meditation and alternative techniques could facilitate. 

  • Marijuana. Research shows that marijuana lowers eye pressure in individuals with eye disease, however just for 3 to four hours. Other, customary treatments are unit simpler. The yankee Academy of medical specialty does not advocate marijuana for treating eye disease. 

Coping and support

When you receive a designation of eye disease, you are doubtless facing long treatment, regular checkups and therefore the risk of progressive vision loss.

Meeting and talking with people with eye disease will be terribly useful, and lots of support teams exist. sit down with hospitals and eye care centers in your space to search out native teams and meeting times. many on-line resources, together with support teams, are offered.

Preparing for your appointment

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment make a list of:

  • Symptoms you've been having, and for how long

  • All medications, supplements and vitamins you take, including the doses

  • Any eye problems you've had in the past, such as vision changes or eye discomfort

  • Family members with glaucoma, what type of glaucoma they had and how severe the condition was for them

  • Previous, if any, glaucoma testing — for example, visual fields, imaging or eye exam records

  • Questions to ask your doctor

Some basic questions to ask your doctor include:

  • Do I have signs of glaucoma?

  • What tests do I need to confirm a diagnosis?

  • What treatment approach do you recommend?

  • What are the alternatives to the primary approach you're suggesting?

  • Do I need to follow any activity restrictions?

  • What other self-care measures might help me?

  • What is the long-term outlook in my case?

  • How often do I need to return for follow-up visits?

  • Do I need to see an additional specialist?

  • I have other health conditions. How can I best manage them together?

What to expect from your doctor

A doctor who sees you for possible glaucoma is likely to ask you a number of questions, such as:

  • Have you had any eye discomfort or vision problems?

  • Do you have any other signs or symptoms that concern you?

  • Do you have any family history of glaucoma or other eye problems?

  • What eye screening tests have you had and when?

  • Have you been diagnosed with any other medical conditions?

  • Are you using any eye drops?

  • Are you using any vitamins or supplements?

General summary

and Cataract Treatments and Procedures Glaucoma is a disease of the optic nerve in the eye which leads from the retina to the brain If left untreated glaucoma causes loss of vision leading to blindness The most common type of glaucoma is called open-angle glaucoma (OAG) People with OAG usually have no idea there's anything wrong until they begin losing their peripheral or side vision Cataracts are growths on the lens that cause blurred cloudy vision They are common in people over age 60 and are treatable by surgery Implanting

Glaucoma is a group of diseases characterized by progressive optic nerve damage resulting in loss of vision Glaucoma has no cure but it can be controlled if detected and treated early on The exact causes are unknown although numerous studies have shown that elevated pressure inside the eye plays an important role Additional risk factors include African or Italian ancestry tobacco use family history cataract surgery with complications or prior trauma to the eye A comprehensive eye exam is necessary for detecting glaucoma at its earliest stages If you suspect that your eyesight may be getting worse it's essential to consult an ophthal

What is the most common treatment for glaucoma?

Two medications are used to treat glaucoma One is taken as eye drops and the other is a pill that must be swallowed Both lower pressure inside the eye thereby slowing the damage being done to your optic nerve To control pressure in your eyes long-term you will need ongoing treatment with one or both of these medications for the rest of your life If you don't get this treatment it's likely that glaucoma will cause gradual loss of vision over time

Can glaucoma be stopped?

If you have glaucoma and it's progressing your ophthalmologist may recommend laser surgery called trabeculoplasty This procedure involves perforations in a tiny flap of tissue at the bottom of your eye that prevents fluid from draining away The doctor will make two small incisions to deliver the laser light along the surface of this flap As the flap heals over time it will no longer prevent fluid from leaving your eye preventing further damage Typically trabeculoplasty is used as an alternative to glaucoma filtration surgery or when other glaucoma medications are not

What foods to avoid if you have glaucoma?

What causes glaucoma? The exact cause of glaucoma is unknown However most experts believe that it is caused by an imbalance in the production and drainage of a clear liquid (aqueous humor) inside the eye that nourishes the optic nerve and cornea As this fluid builds up behind the lens inside your eye and increases pressure it can damage your optic nerve preventing visual images from being sent to the brain Over time increased intraocular pressure associated with glaucoma can permanently damage vision by robbing you of your central field of vision; peripheral vision may also be affected

Can you live a normal life with glaucoma?

In more serious cases glaucoma can cause total blindness before the age of 40. The only treatment is to prevent further damage by lowering the pressure in the eye with eye drops or by laser surgery if other treatments fail Doctors must monitor patients with glaucoma regularly and treat them early to prevent severe eyesight loss In fact some studies have shown that people who suffer from glaucoma avoid going blind for longer periods of time than those who don't have regular checkups and follow-up care

How long do glaucoma patients live?

The National Eye Institute estimates that there are more than 2.2 million people in the United States living with glaucoma and many others who know they have it but haven’t been officially diagnosed. It is one of the leading causes of preventable blindness affecting nearly two percent of Americans over 40. For those people who aren’t yet ready to give up their sight there are options available for slowing vision loss and stabilizing vision

How can I lower my eye pressure fast?

Don't let your eyes get you down If you have high eye pressure there are steps you can take to lower it A daytime sleepiness disorder called nyctalopia is associated with elevated eye pressure and can occur when the body does not get enough sleep at night However during the day failing to obtain adequate rest in a well-lit room by napping or putting on dark sunglasses is recommended for people who suffer from this problem Staying hydrated by drinking plenty of fluids and getting regular exercise will help as well

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Glaucoma: Causes, Types, Symptoms, Diagnosis and Treatment

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