The disease glaucoma, which is also known colloquially as glaucoma, is one of the eye diseases and is treated by ophthalmologists both on an outpatient and inpatient basis. Green star is to be differentiated from the disease cataract.
What is glaucoma?
The definition of glaucoma, or glaucoma, is based on the fact that the optic nerve responsible for vision in particular is damaged by various influences and can no longer perform its function.
The common hallmarks of glaucoma are narrowing of the field of vision and visual field as well as internal pressure in the eyes that is above the normal limit.
In glaucoma or glaucoma, a distinction is made between varying types of disease. These deviating forms of glaucoma differ from one another in terms of their symptoms to a greater or lesser extent. Most patients with glaucoma are diagnosed with what is known as open-angle glaucoma.
In addition to this glaucoma, angle-block, angle-closure and secondary glaucoma also play an important role. A special form of glaucoma is normal pressure glaucoma.
There is not just one single cause for the development of glaucoma. A multitude of different complexes of triggers can lead to glaucoma or glaucoma. Basically, glaucoma is closely related to the changed internal pressure in the eye.
In addition, an inadequate supply of blood to the optic nerve is also a condition that can cause glaucoma. These causes are the so-called risk factors that favor glaucoma. The basis for abnormal intraocular pressure is primarily a disproportion between the provision and the drainage of the eye water required in the eye chamber.
Continuous pressure is created on the optic nerve, which constricts it and contributes to a deterioration in vision. In addition, irregular and low blood pressure, advanced age, nearsightedness and farsightedness, metabolic diseases and a thin-layered cornea are other causes. In addition, there may also be a genetic predisposition that could be the reason for glaucoma.
Symptoms, ailments & signs
Glaucoma is often diagnosed late because it initially remains symptom-free. This mainly applies to primary open-angle glaucoma. When it is recognized, the only option left is often to prevent the disease from getting worse. Open-angle glaucoma becomes noticeable through increasing visual disturbances, in which the field of vision is narrowed from the outside.
Failures can also occur towards the center of the gaze. Without treatment, there is a risk of complete vision loss. If there is a sudden increase in intraocular pressure, what is known as an angular block may occur. It is a medical emergency characterized by sudden severe pain in one eye and the corresponding half of the head, an extremely hard eyeball, red eye, and the perception of rainbow-like rings and veils around light sources.
At the same time, there is nausea and vomiting. Without immediate treatment, there is a risk of blindness. Secondary glaucoma can also lead to blindness. Your symptoms will vary depending on the cause. The most common secondary open-angle glaucoma is so-called PEX glaucoma in older patients.
Here, too, the symptoms appear very late with the impairment of vision at the periphery and in the center of the field of vision and the appearance of double images. If left untreated, blindness often occurs here too. In babies, congenital glaucoma can quickly lead to severe visual damage or even blindness if it is not treated in time.
The course and development of glaucoma (glaucoma) are individually variable and differ in their symptoms.
The affected patients suffer from an impairment that contributes to the fact that the aqueous humor of the eye cannot drain off sufficiently.
Acute glaucoma occurs due to the increasing intraocular pressure. Intense headache, redness of the eyes, dizziness, vomiting, nausea, chills and fever occur.
Other classic accompanying symptoms in glaucoma are a restricted, very limited field of vision, so-called facial deficits and blurred perception of images. Some patients report seeing colored ring structures around bright lights. In glaucoma, the field of vision is foggy.
Since glaucoma or glaucoma only develops symptoms in the form of visual disturbances or loss of vision at an advanced stage, the disease is usually noticed and treated very late. This means that there is already considerable damage to the optic nerves. In many cases, special eye drops are the treatment of choice.
However, depending on the stage of the disease, it may also be necessary to have glaucoma surgery to preserve the remaining eyesight. If the glaucoma is not treated, the affected eye can become completely blind. In many patients with glaucoma, the condition can be treated with eye drops.
Today prostaglandins or alpha agonists, which can very effectively reduce intraocular pressure, are mostly used for this. However, if the eye drops are insufficient, an artificial drain is created as part of an eye operation to permanently equalize pressure in the eye. During the operation, bleeding may occur in the anterior chamber in rare cases, but this will subside by itself.
There are also laser surgical treatments for glaucoma, but these lower intraocular pressure only slightly and not permanently. With a special form of glaucoma, congenital glaucoma, there are early signs in adults such as watery eyes, sensitivity to light or clouded cornea. This inherited form can only be treated with surgery to avoid increasing visual disturbances.
When should you go to the doctor?
If the person concerned suffers from impaired vision, he needs a medical examination. If there are changes in existing eyesight, there is cause for concern. Field of view restrictions and blurred vision should be investigated and treated. A doctor visit is required as soon as there is pain in the eyes or head. If the pain persists for several days, a doctor should be consulted as soon as possible.
The use of a pain reliever medication should always be discussed with a doctor in advance. If you are sensitive to light or have impaired vision under normal lighting conditions, you should consult a doctor. If reddening of the eyes or eyelids is noticed, it is advisable to discuss the observations with a doctor.
If dizziness, nausea, or vomiting persists, a doctor should be consulted. Help is necessary if the risk of an accident increases due to the symptoms. Adults over 40 years of age should take part in the preventive medical check-ups that are offered every year.
In the check-ups, even the smallest changes and irregularities can be detected, which are often not noticed in everyday life. Since glaucoma leads to blindness if left untreated, a doctor should be consulted in good time if the first impairment of vision occurs. If you experience psychological stress, fluctuations in blood pressure or anxiety, you should see a doctor.
Treatment & Therapy
Acute glaucoma is treated like an emergency. Appropriate diagnostics and detection as early as possible can significantly improve the success of treatment in glaucoma. First of all, drug therapy is possible, which can be supplemented by medical intervention using laser technology and other more or less invasive surgical procedures.
The medication focuses on eye drops as beta blockers, cholinergics, prostaglandins and other groups of active ingredients. The drugs are intended to lower intraocular pressure, increase the transparency of the ciliary body and promote the outflow of aqueous humor. In many cases, these drugs are administered in combination.
Laser operations in the treatment of glaucoma include obliteration of the ciliary body, argon laser trabeculoplasty and laser-assisted optimization of the passage of the aqueous humor between the posterior chamber and the anterior chamber.
Another laser technology variant to treat glaucoma is the iridectomy.
Surgical techniques performed on the ciliary body, dermis, and conjunctiva improve eyesight in glaucoma and prolong the course of the disease. Surgical treatment of the iris and a so-called cataract operation can also reduce intraocular pressure.
Outlook & forecast
Glaucoma often leads to complete blindness. This can be justified with the creeping course of the disease. Those affected do not notice anything about their illness for a long time. If the visual deterioration is perceived, the optic nerve is usually already severely damaged.
Treatment that starts immediately will no longer improve the prognosis. Regular checkups by an ophthalmologist are advisable to improve the prognosis. It is therefore necessary to act in advance in order to avoid consequential damage. This is especially true for certain risk groups.
People over 40 years of age, people who have had glaucoma in their families, or diabetics are at greater risk. The treatment is primarily about lowering intraocular pressure. If impairments have already occurred, treatment is aimed at preventing the disease from progressing further. The disease is insidious, but it is always chronic.
Treated in time, the prognosis is quite positive and the course can be slowed down or stopped. However, the patient must reckon with impaired vision. However, timely treatment can often prevent blindness. Untreated glaucoma leads to complete blindness without exception.
An individual prophylaxis against glaucoma is hardly possible, only a good perception of the eyesight and a quick reaction in case of deterioration can enable early detection.
A diagnosis of glaucoma can only be carried out by a specialist and is the prerequisite for successful therapy, which can begin at an early stage.
Especially with diseases that are associated with circulatory disorders, such as the metabolic disease diabetes mellitus, regular eye checks by the ophthalmologist with a measurement of the intraocular pressure is essential.
Proper follow-up care for glaucoma is critical to the success of treatment. Follow-up care is very individual and can take many weeks or years. It is medicinal and controlling in nature. First of all, it is necessary to have the eyes checked regularly, even after a treatment that is considered to be completed.
An intraocular pressure measurement is the most important component. It can never be completely ruled out that the glaucoma will recur. In addition, a temporary impairment of vision after an operation on the eye is normal, which the patient should bear in mind for the time of his follow-up care.
Immediately after the operation, preparations may be used to lower intraocular pressure. In addition, funds are prescribed that are designed to inhibit scarring. The aim is to ensure that surgical scars do not restrict the field of vision. Tablets or drops are also prescribed over a period of time for wound healing and tissue regeneration.
Furthermore, the type of follow-up also depends on the selected surgical procedure. Surgical interventions require different follow-up measures than pure laser operations. Occasionally it may be necessary to have another surgical treatment because the desired result has not been achieved. As with glaucoma treatment, follow-up care is based on the principle of starting with the least invasive procedures.
You can do that yourself
Glaucoma cannot be treated independently. Once diagnosed, the damaged optic nerve can usually only be restored with the help of surgical measures or medication.
In the early stages, the spread of glaucoma can be delayed or even prevented by changing your lifestyle. Above all, experts recommend comprehensive eye care, regular exercise and a healthy and balanced diet. Those affected should avoid sugary foods as well as caffeine, alcohol and nicotine.
Instead, foods that cleanse and detoxify the body should be consumed, such as fruits and vegetables as well as sprouts and sprouts. Regular therapeutic fasting is particularly effective. At the same time, it is important to reduce stress and, above all, to reduce the strain on the eyes.
Anyone who works on the computer every day can significantly reduce the risk of glaucoma through targeted eye training and at the same time provide psychological relief. An effective exercise: extend your arm with your thumb upright, move it in different directions, following your thumb with your eyes while your head does not move.
Finally, regular preventive examinations should be carried out by an ophthalmologist. Above all, risk groups (people over 40, patients with other eye diseases, etc.) should take these measures and thereby effectively counteract glaucoma.