Mild glaucoma: Glaucoma – Symptoms and causes
Glaucoma – Diagnosis and treatment
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)
The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages.
Glaucoma is treated by lowering your eye pressure (intraocular pressure). Depending on your situation, your options may include prescription eyedrops, oral medications, laser treatment, surgery or a combination of any of these.
Glaucoma treatment often starts with prescription eyedrops. These can help decrease eye pressure by improving how fluid drains from your eye or by decreasing the amount of fluid your eye makes. Depending on how low your eye pressure needs to be, more than one of the eyedrops below may need to be prescribed.
Prescription eyedrop medications include:
Prostaglandins. These increase the outflow of the fluid in your eye (aqueous humor), thereby reducing your eye pressure. Medicines in this category include latanoprost (Xalatan), travoprost (Travatan Z), tafluprost (Zioptan), bimatoprost (Lumigan) and latanoprostene bunod (Vyzulta).
Possible side effects include mild reddening and stinging of the eyes, darkening of the iris, darkening of the pigment of the eyelashes or eyelid skin, and blurred vision. This class of drug is prescribed for once-a-day use.
Beta blockers. These reduce the production of fluid in your eye, thereby lowering the pressure in your eye (intraocular pressure). Examples include timolol (Betimol, Istalol, Timoptic) and betaxolol (Betoptic).
Possible side effects include difficulty breathing, slowed heart rate, lower blood pressure, impotence and fatigue. This class of drug can be prescribed for once- or twice-daily use depending on your condition.
Alpha-adrenergic agonists. These reduce the production of aqueous humor and increase outflow of the fluid in your eye. Examples include apraclonidine (Iopidine) and brimonidine (Alphagan P, Qoliana).
Possible side effects include an irregular heart rate, high blood pressure, fatigue, red, itchy or swollen eyes, and dry mouth. This class of drug is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day.
- Carbonic anhydrase inhibitors. These medicines reduce the production of fluid in your eye. Examples include dorzolamide (Trusopt) and brinzolamide (Azopt). Possible side effects include a metallic taste, frequent urination, and tingling in the fingers and toes. This class of drug is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a 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 example is pilocarpine (Isopto Carpine). Side effects include headache, eye ache, smaller pupils, possible blurred or dim vision, and nearsightedness. This class of medicine is usually prescribed to be used up to four times a day. Because of potential side effects and the need for frequent daily use, these medications are not prescribed very often anymore.
Because some of the eyedrop medicine is absorbed into your bloodstream, you may experience some side effects unrelated to your eyes. To minimize this absorption, close your eyes for one to two minutes after putting the drops in. You may also press lightly at the corner of your eyes near your nose to close the tear duct for one or two minutes. Wipe off any unused drops from your eyelid.
If you have been prescribed multiple eyedrops or you need to use artificial tears, space them out so that you are waiting at least five minutes in between types of drops.
If eyedrops alone don’t bring your eye pressure down to the desired level, your doctor may also prescribe an oral medication, usually a carbonic anhydrase inhibitor. Possible side effects include frequent urination, tingling in the fingers and toes, depression, stomach upset, and kidney 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 (truh-BEK-u-low-plas-tee) is an option if you have open-angle glaucoma. It’s done in your doctor’s office. Your doctor uses a small laser beam to open clogged channels in the trabecular meshwork. It may take a few weeks before the full effect of this procedure becomes apparent.
- Filtering surgery. With a surgical procedure called a trabeculectomy (truh-bek-u-LEK-tuh-me), your surgeon creates an opening in the white of the eye (sclera) and removes part of the trabecular meshwork.
- 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 may suggest a MIGS procedure to lower your eye pressure. These procedures generally require less immediate postoperative care and have less risk than trabeculectomy or installing a drainage device. They are often combined with cataract surgery. There are a number of MIGS techniques available, and your doctor will discuss which procedure may be right for you.
After your procedure, you’ll need to see your doctor for follow-up exams. And you may eventually need to undergo additional procedures if your eye pressure begins to rise or other changes occur in your eye.
Treating acute angle-closure glaucoma
Acute angle-closure glaucoma is a medical emergency. If you’re diagnosed with this condition, you’ll need urgent treatment to reduce the pressure in your eye. This generally will require both medication and laser or other surgical procedures.
You may have a procedure called a laser peripheral iridotomy in which the doctor creates a small opening in your iris using a laser. This allows fluid (aqueous humor) to flow through it, relieving eye pressure.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
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 only moderate amounts of fluids at any given time during the course of a day. Drinking a quart or more of any liquid within a short time may temporarily 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 other medications as prescribed can help you get the best possible result from your treatment. Be sure to use the drops exactly as prescribed. Otherwise, your optic nerve damage could worsen.
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 herbal supplements, such as bilberry extract, have been advertised as glaucoma remedies. But further study is needed to prove their effectiveness. Don’t use herbal supplements in place of proven therapies.
- Relaxation techniques. Stress may trigger an attack of acute angle-closure glaucoma. If you’re at risk of this condition, find healthy ways to cope with stress. Meditation and other techniques may help.
- Marijuana. Research shows that marijuana lowers eye pressure in people with glaucoma, but only for three to four hours. Other, standard treatments are more effective. The American Academy of Ophthalmology doesn’t recommend marijuana for treating glaucoma.
Coping and support
When you receive a diagnosis of glaucoma, you’re potentially facing lifelong treatment, regular checkups and the possibility of progressive vision loss.
Meeting and talking with other people with glaucoma can be very helpful, and many support groups exist. Check with hospitals and eye care centers in your area to find local groups and meeting times. Several online resources, including support groups, also are available.
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 eyedrops?
- Are you using any vitamins or supplements?
Oct. 23, 2020
Eye vitamins: Can they prevent or treat glaucoma?
I have glaucoma. Can eye vitamins improve my vision or protect me from further vision loss?
Answer From Alaina L. Softing Hataye, O.D.
Probably not. Several dietary supplements are marketed as eye vitamins. But little evidence supports using these products for preventing glaucoma or reversing vision loss due to glaucoma.
Few clinical trials of eye vitamins or supplements for glaucoma have been conducted. Some evidence suggests that a high intake of vitamin B through dietary sources, including green leafy vegetables, may reduce the risk of some types of glaucoma. But B complex supplements, including folic acid, vitamin B6 and vitamin B12, don’t appear to offer the same benefit.
Other studies have found that antioxidants as well as natural compounds such as Ginkgo biloba, tropical fruits and green tea, among others, may slow the progression of glaucoma, but the evidence so far is weak. And while some research has found that vitamin C supplements may decrease the risk of getting glaucoma, more research is needed.
If you’re interested in trying eye vitamins or supplements, discuss the benefits and risks with your eye doctor.
Alaina L. Softing Hataye, O.D.
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Feb. 07, 2020
- Antón-López, et al. Lifestyles guide and glaucoma (II). Diet, supplements, drugs, sleep, pregnancy, and systemic hypertension. Archivos de la Sociedad Espanola de Oftalmología. 2018;93:76.
- Kang JH, et al. A prospective study of folate, vitamin B-6 and vitamin B-12 intake in relation to exfoliation glaucoma or suspected exfoliation glaucoma. JAMA Ophthalmology. 2014;132:549.
- Kang JH, et al. Association of dietary nitrate intake with primary open-angle glaucoma: A prospective analysis from the Nurses’ Health Study and Health Professionals Follow-up Study. JAMA Ophthalmology. 2016;134:294.
- Rakel D, ed. Age-related macular degeneration. In: Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Jan. 26, 2018.
- Pinazo-Duran MD, et al. Strategies to reduce oxidative stress in glaucoma patients. Current Neuropharmacology. In press. Accessed Jan. 26, 2018.
- Softing Hataye AL (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 9, 2018.
See more Expert Answers
Know the New Glaucoma Staging Codes
By Ronald L. Fellman, MD, OCS, Cynthia G. Mattox, MD, Kim M. Ross, OCS, CPS, Academy Coding Specialist, and Sue Vicchrilli, COT, OCS, Academy Coding Executive
This article is from October 2011 and may contain outdated material.
Update: The AGS tutorial on grading the severity of glaucoma is now available.
Other common eye diseases have them; why not glaucoma? That is, codes indicating disease severity. ICD-9 severity codes already exist for macular degeneration, diabetic retinopathy, cataract and even retinopathy of prematurity. Finally, effective Oct. 1, 2011, new ICD-9 codes allow staging of glaucoma into mild, moderate and severe disease based simply on the physician’s analysis of the printout of the visual field in the patient’s worse eye. The new codes are listed below and are signified by an asterisk (*).
Given the great variability in costs of care and resource utilization among glaucoma patients, glaucoma care will be targeted for the use of potential value-based modifiers in coming years. To prepare for this possibility, ICD-9/ICD-10 codes reflecting disease severity will allow for stratification of a patient population in a practice.
Consider two patients, both under the care of a single physician. Both patients have primary open-angle glaucoma. The first has minimal damage that requires one medication and follow-up visits twice a year; the second has advanced disease that requires multiple medications, numerous visits and surgery. Under the old system, payers and researchers who used claims-based data were unable to distinguish between these two patients, as both would have been coded with 365.11. But with the new codes, their physician can accurately indicate each patient’s disease severity.
Step One: Code by Type
To get started, first code the type of glaucoma (only those listed below require the add-on staging codes):
365.10 Open-angle glaucoma, unspecified
365.11 Primary open-angle glaucoma
365.12 Low-tension glaucoma (also used for normal-tension glaucoma)
365.13 Pigmentary glaucoma
365.20 Primary angle-closure glaucoma, unspecified
365.23 Chronic or primary angle-closure glaucoma
365.31 Steroid-induced glaucoma
365.52 Pseudoexfoliation glaucoma
365.62 Glaucoma associated with ocular inflammations
365.63 Glaucoma associated with vascular disorders
365.65 Glaucoma associated with ocular trauma
Step Two: Add Stage
Second, determine the severity of the glaucoma in the worse eye, based on the new ICD-9 staging definitions (see “Visual Fields Examples”):
*365.71 Mild or early-stage glaucoma (defined as optic nerve abnormalities consistent with glaucoma but no visual field abnormalities on any white-on-white visual field test, or abnormalities present only on short-wavelength automated perimetry or frequency-doubling perimetry)
*365.72 Moderate-stage glaucoma (optic nerve abnormalities consistent with glaucoma and glaucomatous visual field abnormalities in one hemifield, and not within 5 degrees of fixation)
*365.73 Severe-stage glaucoma, advanced-stage glaucoma, end-stage glaucoma (optic nerve abnormalities consistent with glaucoma and glaucomatous visual field abnormalities in both hemifields, and/or loss within 5 degrees of fixation in at least one hemifield)
*365.74 Indeterminate (visual fields not performed yet, or patient incapable of visual field testing, or unreliable/uninterpretable visual field testing)
*365.70 Unspecified, stage not recorded in chart
It is important to document the stage in the patient’s medical record. However, while the new staging definitions must be used after Oct. 1, they will not impact coverage, as current policies link to the primary diagnosis.
Open-angle glaucoma suspects (based on the number of risk factors: family history, race, elevated IOP, optic disc appearance and thin central corneal thickness):
365.01 Open-angle suspect, low risk (one or two risk factors)
*365.05 Open-angle suspect, high risk (three or more risk factors)
365.02 Primary angle-closure suspect (anatomical suspect, narrow angle)*365.06 Primary angle-closure without glaucoma damage (defined as angle damage such as peripheral anterior synechiae or high IOP, but without optic nerve damage)
Primary angle-closure glaucoma:
365.23 Chronic angle-closure glaucoma (angle damage plus optic nerve damage)
Origin of the Staging System
The new glaucoma staging system was developed by an American Glaucoma Society (AGS) work group, which included Drs. Fellman and Mattox. The work group then enlisted comprehensive ophthalmologists, optometrists and a few glaucoma specialists to evaluate and test the accuracy of the severity levels, using real-world cases prepared by Joshua D. Stein, MD, assistant professor of ophthalmology and visual sciences at the University of Michigan in Ann Arbor. Dr. Stein analyzed the responses and found excellent agreement among participants, who also found the system easy to use.
After refinements required by the government’s ICD-9-CM Coordination and Maintenance Committee, the glaucoma staging codes were approved to be implemented on Oct. 1. They will be incorporated into ICD-10 in October 2013.
Boost Your Skills
Teaching guide. The AGS is preparing an online Teaching Set with real-world examples of glaucoma cases. This teaching guide is designed to help you test your coding skills with the new codes. Check the AGS website (www.americanglaucomasociety.net) for a link.
Meeting course. At the Annual Meeting, the American Academy of Ophthalmic Executives is offering a coding course that will cover this material. It’s the “Coding Odyssey” (622) and it takes place on Tuesday, Oct. 25, from 11:30 a.m. to 12:30 p.m.
Dr. Fellman is with Glaucoma Associates of Texas in Dallas; Dr. Mattox is director of the glaucoma and cataract service at the New England Eye Center in Boston.
Summary of Staging Codes
Causes, Types, Symptoms, Diagnosis, and Treatment
National Institutes of Health.
Glaucoma Research Foundation: “Other Types of Glaucoma,” “Questions & Answers: Normal-Tension Glaucoma,” “Symptoms of Angle-Closure Glaucoma,” “Medication Guide,” “What Can I Do To Prevent Glaucoma?” “What You Can Do to Manage Your Glaucoma, “Dry Eyes and Glaucoma: Double Trouble,” “Summertime Tips,” “Learn About Glaucoma,” “How Often Should I Have My Eyes Tested?” “Five Common Glaucoma Tests,” “Glaucoma Medications and Their Side Effects,” “Should You Be Smoking Marijuana to Treat Your Glaucoma?”
American Academy of Ophthalmology: “What Are the Symptoms of Glaucoma?” “Who Is at Risk for Glaucoma?” “What Is Ocular Hypertension?” “Glaucoma Treatment,” “Does Marijuana Help Treat Glaucoma?” “Early Detection Key to Slowing Progression of Glaucoma.”
Mayo Clinic: “Glaucoma.”
CDC: “Don’t Let Glaucoma Steal Your Sight!”
American Glaucoma Society.
Weinreb, R. Lancet, 2004.
Curcio, C. Journal of Comparative Neurology, Oct. 1, 1990.
American Academy of Ophthalmology.
U.S. Preventive Services Task force: “Screening for Primary Open-Angle Glaucoma in the Primary Care Setting.”
Distelhorst, J. American Family Physician, May 1, 2003.
National Eye Institute.
BrightFocus Foundation: “9 Tips for Healthy Living with an Eye Disease.”
Journal of Glaucoma: “Lifestyle, Nutrition and Glaucoma,” “Regulation of intraocular pressure after water drinking.”
Ophthalmology: “Intraocular pressure changes and ocular biometry during Sirsasana (headstand posture) in yoga practitioners.”
AllAboutVision: “Research Says You Should Rethink Your Yoga Routine if You Have Glaucoma.”
U.S. Preventive Services Task Force: “Screening for Primary Open-Angle Glaucoma in the Primary Care Setting.”
Kellogg Eye Center: “Glaucoma.”
American Glaucoma Society: “Position Statement on Marijuana and the Treatment of Glaucoma.”
International Journal of Clinical Nutrition: “Coffee Intake and Progression of Glaucoma.”
National Eye Institute: “Immediate Treatment Helps Delay Progression of Glaucoma.”
Causes, Symptoms, Types, Treatment & Prevention
What is glaucoma?
Glaucoma is a general term used to describe a group of eye disorders that damage the optic nerve. It’s the most common form of optic nerve damage leading to vision loss. In most cases, fluid builds up in the front part of the eye. This extra fluid puts pressure on the eye, gradually damaging the optic nerve. This pressure is known as intraocular pressure (IOP), or eye pressure.
Some people have normal eye pressure and still get glaucoma. Untreated or poorly controlled glaucoma can lead to permanent and irreversible vision loss and blindness.
What is the optic nerve?
Your optic nerve plays a crucial role in vision. It sends signals from the retina (neural tissue in the back of your eye, like the film of an old-fashioned camera) to the brain. Your brain relies on these signals to create images.
How common is glaucoma?
Glaucoma is a common age-related eye problem that affects an estimated three million Americans. Globally, it is the second leading cause of blindness after cataracts.
Who might get glaucoma?
Glaucoma can affects people of all races and genders, but the risk increases with age. African Americans and Latinos are much more likely to get glaucoma than other races, and they tend to develop the disease earlier in life. Asian and Inuit populations are also more susceptible to a specific form of glaucoma known as angle closure glaucoma.
People with diabetes are twice as likely to get glaucoma. Other risk factors include:
What are the types of glaucoma?
There are several types of glaucoma, including:
- Open-angle: This type is the most common, affecting up to 90% of Americans who have glaucoma. It occurs when tiny deposits build up in the eye’s drainage canals, slowly clogging them. The canals appear to be open and functioning normally. But over months or years, the deposits cause fluid to build up and put pressure on the optic nerve. The disease can go unnoticed for years because most people don’t have symptoms.
- Closed-angle: Also called angle-closure or narrow-angle glaucoma, this rare type often comes on suddenly (acute). It occurs when the angle between the iris (the colored part of the eye that controls light exposure) and cornea (clear outer part of the eye) is too narrow. As a result, the drainage canals become blocked, preventing aqueous fluid from leaving the eye and causing an acute elevation in eye pressure. Symptoms, including eye pain and headaches, can be severe and require immediate medical attention.
- Normal-tension: As many as one in three people have optic nerve damage even when eye pressure is normal or not very high. Experts aren’t sure what causes normal-tension glaucoma, which is also called normal-pressure or low-tension glaucoma. This type is more common among Asians and Asian Americans.
- Congenital: Some babies are born with drainage canals that don’t form properly in the womb. Your healthcare provider might notice a baby’s glaucoma symptoms at birth. Or signs may become noticeable during childhood. This condition is also known as childhood, infantile or pediatric glaucoma.
Does glaucoma affect both eyes?
Most people develop glaucoma in both eyes, although the disease initially may be worse in one eye. With open-angle glaucoma, one eye may have moderate or severe damage, while the other eye may be mildly affected. Over time, the disease damages both eyes.
People with closed-angle glaucoma in one eye have a 40% to 80% chance of developing the same type of glaucoma in the other eye within five to 10 years.
Symptoms and Causes
What causes glaucoma?
Glaucoma can occur without any cause, but is affected by many factors. The most important of which is the intraocular eye pressure. Your eyes produce a fluid called aqueous humor that nourishes them. This liquid flows through the pupil to the front of the eye. In a healthy eye, the fluid leaves through a drainage canal located between the iris and cornea.
With glaucoma, the drainage canals become clogged with microscopic deposits. The fluid has nowhere to go, so it builds up in the eye. This excess fluid puts pressure on the eye. Eventually, this elevated eye pressure can damage the optic nerve leading to glaucoma.
What are the symptoms of glaucoma?
Signs of open-angle glaucoma tend to come on subtlety and gradually. That makes them easy to miss. Many people with open-angle glaucoma have no noticeable symptoms early on, which makes it incredibly important to have routine eye exams to detect this disease in its earlier stages. Because glaucoma damage is irreversible, early detection and treatment is crucial to prevent blindness.
Closed-angle glaucoma has more severe symptoms that tend to come on suddenly.
With any type, you may experience:
- Eye pain or pressure.
- Rainbow-colored halos around lights.
- Low vision, blurred vision, narrowed vision (tunnel vision) or blind spots.
- Nausea and vomiting.
- Red eyes.
Diagnosis and Tests
How is glaucoma diagnosed?
It’s possible to have glaucoma and not know it. Regular eye exams are important to catch glaucoma or other eye problems. Eye exams can assess optic health and vision loss.
To check for glaucoma, your eye doctor may do one or more of these painless tests:
- Dilated eye exam to widen pupils and view the optic nerve at the back of the eyes.
- Gonioscopy to examine the angle where the iris and cornea meet.
- Optical coherence tomography (OCT) to look for changes in the optic nerve that may indicate glaucoma.
- Ocular pressure test (tonometry) to measure eye pressure.
- Pachymetry to measure corneal thickness.
- Slit-lamp exam to examine the inside of the eye with a special microscope called a slit lamp.
- Visual acuity test (eye charts) to check for vision loss.
- Visual field test (perimetry) to check for changes in peripheral vision (your ability to see things off to the side).
Management and Treatment
How is glaucoma managed or treated?
Untreated glaucoma can lead to faster development of permanent vision loss or blindness. Treatments can slow down additional vision loss, but they can’t restore lost vision. It’s important to see your eye doctor right away if you have eye pain, severe headaches or vision problems.
Glaucoma treatments include:
- Eyedrops/Medication: Prescription eyedrops decrease fluids and increase drainage to alleviate eye pressure. There are many types of eyedrop medications that can be used for this condition. Because glaucoma is a lifelong condition, you may need to use daily eyedrops for life.
- Laser treatment: Your eye doctor uses a laser (strong beam of light) to help improve fluid drainage from your eye. While the laser can complement the use of eye drops, it may not replace it completely. The results from laser treatments vary, but can last up to five years. Some laser treatments can also be repeated.
- Surgery: Surgery is another way to help reduce eye pressure. It is more invasive but can also achieve better eye pressure control faster than drops or laser. Surgery can help slow down vision loss, but it can’t restore lost vision or cure glaucoma. There are many types of surgeries for glaucoma, and depending on the specific type and severity, your eye doctor may choose one over another.
What are the complications of glaucoma?
An estimated one in 10 people with glaucoma develop some degree of visual impairment. Blindness is rarer, affecting 5% of people with glaucoma.
How can I prevent glaucoma?
Early detection of glaucoma through routine eye exams is the best way to protect eye health and prevent vision loss. Glaucoma testing should occur every:
- 1 to 2 years after age 35 for people at high risk.
- 2 to 4 years before age 40.
- 1 to 3 years between ages 40 and 54.
- 1 to 2 years between ages 55 to 64.
- 6 months to 12 months after age 65.
Outlook / Prognosis
What can I expect if I have glaucoma?
Blindness is a rare complication for people with glaucoma if detected early. However, glaucoma is a chronic and progressive condition that often causes some degree of vision loss over time. The earlier you catch glaucoma and start treatments, the better the odds of saving your vision. Treatments can slow down disease progression and vision loss. If you’re at high risk for glaucoma, regular eye exams are a must.
When should I call the doctor?
You should call your healthcare provider if you experience:
- Blurred or low vision.
- Halos, eye floaters or flashers.
- Sudden, severe eye pain or headaches.
- Sensitivity to light.
- Vision loss.
What questions should I ask my doctor?
You may want to ask your healthcare provider:
- Why did I get glaucoma?
- What type of glaucoma do I have?
- What is the best treatment for the type of glaucoma I have?
- Are there any treatment risks or side effects?
- What lifestyle changes can I make to protect my vision?
- Should I watch for signs of complications?
A note from Cleveland Clinic
While there isn’t a cure for glaucoma, treatments can keep eye pressure under control and prevent vision loss. Eye exams can catch the disease early and save your sight. If you’re at high risk for glaucoma, ask your eye doctor how often you need screenings. If you have glaucoma, it’s important to use daily eyedrops as prescribed. You can also ask your provider about laser treatments and surgery options. With proper care, you can keep glaucoma from worsening and causing irreversible vision loss or blindness.
Don’t Let Glaucoma Steal Your Sight!
Half of people with glaucoma don’t know they have it. Get a healthy start this year by learning about glaucoma and taking steps to reduce your risk of vision loss!
Know the Facts About Glaucoma
- Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and even blindness.
- About 3 million Americans have glaucoma. It is the second leading cause of blindness worldwide.
- Open-angle glaucoma, the most common form, results in increased eye pressure. There are often no early symptoms, which is why 50% of people with glaucoma don’t know they have the disease.
- There is no cure (yet) for glaucoma, but if it’s caught early, you can preserve your vision and prevent vision loss. Taking action to preserve your vision health is key.
Know Your Glaucoma Risk
Anyone can get glaucoma, but certain groups are at higher risk. These groups include African Americans over age 40, all people over age 60, people with a family history of glaucoma, and people who have diabetes. African Americans are 6 to 8 times more likely to get glaucoma than whites. People with diabetes are 2 times more likely to get glaucoma than people without diabetes.
Healthy habits can help you avoid vision loss from glaucoma.
Take Action to Prevent Vision Loss
There are many steps you can take to help protect your eyes and lower your risk of vision loss from glaucoma.
- If you are in a high-risk group, get a comprehensive dilated eye exam to catch glaucoma early and start treatment. Prescription eye drops can stop glaucoma from progressing. Your eye care specialist will recommend how often to return for follow-up exams. Medicare covers a glaucoma test once a year for people in high-risk groups.
- Even if you are not in a high-risk group, getting a comprehensive dilated eye exam by the age of 40 can help catch glaucoma and other eye diseases early.
- Open-angle glaucoma does not have symptoms and is hereditary, so talk to your family members about their vision health to help protect your eyes—and theirs.
- Maintaining a healthy weight, controlling your blood pressure, being physically active, and avoiding smoking will help you avoid vision loss from glaucoma. These healthy behaviors will also help prevent type 2 diabetes and other chronic conditions.
CDC funds programs to detect glaucoma and other eye diseases among high-risk communities and provide successful follow-up care. Read more about our glaucoma initiatives.
Manage and Treat Glaucoma
Vision loss from glaucoma usually affects peripheral vision (what you can see on the side of your head when looking ahead) first. Later, it will affect your central vision, which is needed for seeing objects clearly and for common daily tasks like reading and driving.
Glaucoma is treated with eye drops, oral medicine, or surgery (or a combination of treatments) to reduce pressure in the eye and prevent permanent vision loss. Take medicine as prescribed, and tell your eye care specialist about any side effects. You and your doctor are a team. If laser or surgical procedures are recommended to reduce the pressure in your eye, make sure to schedule regular follow-up visits to continue to monitor eye pressure.
Learn About Low Vision
Some people with glaucoma have low vision, which means they have a hard time doing routine activities even with the help of glasses or contacts. See the “Low vision resources for glaucoma” link below for more information.
What Can I Do to Prevent Glaucoma?
Currently, regular eye exams are the best form of prevention against significant glaucoma damage.
Early detection and careful, lifelong treatment can maintain vision in most people. In general, a check for glaucoma should be done:
- before age 40, every two to four years
- from age 40 to age 54, every one to three years
- from age 55 to 64, every one to two years
- after age 65, every six to 12 months
Anyone with high risk factors should be tested every year or two after age 35. Those at higher risk include people of African descent, people with diabetes, and people with a family history of glaucoma. You are at increased risk if you have a parent or brother or sister with glaucoma.
Timely Diagnosis and Appropriate Treatment are Key to Glaucoma Prevention
While there are no known ways of preventing glaucoma, blindness or significant vision loss from glaucoma can be prevented if the disease is recognized in the early stages. In its most prevalent form—primary open angle glaucoma—vision loss is silent, slow, and progressive. It typically affects side vision first (peripheral vision) and as it progresses, central vision is lost.
Glaucoma medications slow the progression of glaucoma by reducing elevated intraocular pressure (IOP) to prevent damage to the optic nerve. Surgical treatments are also available.
Benefits of Exercise
A regular program of moderate exercise will benefit your overall health, and studies have shown that moderate exercise such as walking or jogging three or more times every week can have an IOP lowering effect.
The benefits from exercise last only as long as you continue exercising; this is why moderate exercise on a routine basis is recommended. Yoga can be beneficial, but it’s best to avoid inverted positions such as headstands and shoulderstands, as these may increase IOP.
Talk with your doctor if you have specific questions or concerns about starting an exercise program.
Protect Your Eyes
Wearing protective eyewear is important when engaged in sports activities or home improvement projects.
Eye injuries can result in traumatic glaucoma or secondary glaucoma, so protecting your eyes from injury is another way to prevent glaucoma. Click here for more information about different types of glaucoma, or talk with your eye doctor.
Remember, regular comprehensive eye exams are the best form of prevention against glaucoma and other eye diseases.
Article by Robert L. Stamper, MD, Distinguished Professor of Clinical Ophthalmology and Director Emeritus of the Glaucoma Service at University of California San Francisco.
90,000 prices, ophthalmologist consultation at the Excimer clinic
Glaucoma is a dangerous disease in which intraocular pressure rises, pathology of the optic nerve develops up to atrophy. In 90% of cases, open-angle glaucoma is diagnosed – insidious in that it begins to develop asymptomatically and does not bother for a long time. Therefore, for patients at risk (people over 50 with high degrees of myopia and hyperopia, patients with a genetic predisposition to glaucoma, patients with certain chronic diseases, those who have suffered eye injuries) it is especially important to undergo regular vision diagnostics in order to detect glaucoma at an early stage.
The goal of glaucoma treatment is to normalize intraocular pressure and prevent irreversible vision loss. In the arsenal of modern ophthalmologists, there are reliable ways to solve this problem. But remember that in the fight against the disease, the joint efforts of the patient and the doctor are important!
Depending on individual indications, the following methods of glaucoma diagnostics can be offered to our patients:
- Tonometry .A diagnostic procedure necessary to assess the risk of developing glaucoma, which consists in measuring the intraocular pressure (IOP). Tonometry is also widely used by ophthalmologists to monitor the state of IOP in dynamics.
- Perimetry . Study of the visual field, one of the methods for diagnosing glaucoma, partial atrophy of the optic nerve.
- Gonioscopy . During gonioscopy, the anterior chamber of the eyeball is examined and the type of glaucoma (closed-angle or open-angle) is determined.
- Biomicroscopy . A procedure for examining various parts of the eye using a special ophthalmic microscope – a slit lamp. In biomicroscopy, the conjunctiva, cornea, iris, vitreous body, lens, and central fundus are examined in detail.
- Optical Coherence Tomography . The most modern method for studying various structures of the visual system. With OCT, two- and three-dimensional images of the retina and optic nerve head can be taken.
- Pachymetry . Diagnostics, which can be used to measure the size of the lens – in some cases, glaucoma develops due to its parameters that do not correspond to the norm.
How to deal with glaucoma?
There is no cure for glaucoma. But modern technologies to combat this disease are able to stop its progression. For this, drug therapy and surgical methods are used.
The doctor will recommend the best treatment method – based on the results of a comprehensive examination of the visual system using modern diagnostic equipment.
Conservative (medical) treatment
Treatment with antiglaucoma drugs of the latest generation is aimed primarily at reducing the production of intraocular fluid, as well as improving its outflow, and IOP is normalized.
But drug treatment is often effective only in the early stages of glaucoma. In addition, conservative therapy is not suitable for all patients due to possible side effects of drugs, the presence of vascular diseases in people, bronchial asthma and some endocrine pathologies.In addition, any long-term drug therapy loses its effectiveness over time. Therefore, the most effective method of treating glaucoma is surgery.
The operation makes it possible to prevent the deterioration of vision, which threatens irreversible blindness in glaucoma.
During the operation, special miniature devices can be implanted into the eye, which perform the function of an alternative outflow of fluid in the event of an increase in intraocular pressure.In the Excimer clinic, antiglaucoma operations are performed using the EXPRESS drainage, the Glautex biodegradable drainage, and the drainage system (AHMED valve).
With closed-angle forms of glaucoma, both traditional surgical and laser operations are performed.
- Laser iridotomy (IAG) . An intervention that creates a microscopic hole or multiple holes near the iris to lower IOP.According to statistics, after laser iridotomy, intraocular pressure normalizes in 90% of patients.
- Selective laser trabeculoplasty . The purpose of the procedure is to normalize intraocular pressure. To do this, during the operation, the blockade of the outflow of intraocular fluid is removed.
If glaucoma is caused by the fact that the size of the lens does not match the size of the eye, ophthalmic surgeons use the method of removing the lens with simultaneous implantation of an intraocular lens.As a result, the natural circulation of fluid in the eye is restored, which prevents loss of vision.
Simultaneous treatment of glaucoma and cataract
What is the difference between cataract and glaucoma?
Cataract is a disease caused by age-related changes in the lens. With cataracts, it gradually becomes cloudy, losing transparency and elasticity. For these reasons, a person’s vision deteriorates. Glaucoma develops against the background of increased intraocular pressure.As a result of pathological processes, there is a high risk of optic nerve atrophy, which can lead to blindness.
At the Excimer clinic, one-stage surgical treatment of cataracts and glaucoma is carried out. This procedure preserves eye health and restores visual acuity without the need for additional surgery.
In the case of a combination of cataract and secondary glaucoma as its consequence in the Excimer clinic, the patient can be prescribed ultrasonic phacoemulsification of cataract with implantation of an intraocular lens, an artificial lens, and the intraocular pressure returns to normal.Ultrasonic phacoemulsification effectively treats cataracts and stops the further development of glaucoma.
If a cataract has developed against the background of an existing glaucoma, the Excimer clinic performs two operations simultaneously: ultrasonic phacoemulsification of a cataract and an antiglaucoma operation, if necessary, performed with the use of special drains.
As a result of antiglaucoma surgery, the natural balance of fluid in the eye is restored, intraocular pressure is normalized.Ultrasonic phacoemulsification allows you to get rid of cataracts.
Treatment of glaucoma in the elderly
Many elderly people associate deterioration of vision with age and go to the doctor when they began to see very badly. The fact is that open-angle glaucoma – and this type of pathology is more often diagnosed in older patients – develops slowly, but it can be detected at early diagnosis and treatment can be started that will help preserve vision.
Glaucoma can be suspected by the following signs : the appearance of a veil before the eyes, frequent migraines, halos before the eyes, a feeling of pressure on the eyeballs, narrowing of the visual fields.
In 90% of cases, elderly patients suffer from open-angle glaucoma. In this case, antiglaucoma surgery becomes an effective method of treatment. This surgery can restore the natural fluid balance in the eye.
What is the norm for intraocular pressure in glaucoma?
The level of normal intraocular pressure depends on how it is measured. When measured with a 5 g weight, it varies from 11 to 21 mm Hg.Art. With a non-contact assessment of the pressure level, the norm is from 9 to 21 mm Hg.
How old can a person with glaucoma live?
According to statistics, the average life expectancy for men with glaucoma is on average 69 years, for women – 70 years.
Emergency care for an acute attack of glaucoma
The main goal of treatment for an acute attack of glaucoma is a rapid decrease in intraocular pressure and normalization of blood circulation in the eye to restore nutrition to the retina and optic nerve.
The risk group includes people suffering from angle-closure glaucoma. Often an attack can occur due to stress, hypothermia, increased physical exertion, prolonged work with a head tilt.
A characteristic symptom of an acute attack of glaucoma is a sharp pain in the eye, which is given by a headache and is often accompanied by nausea, vomiting, discomfort in the heart and bradycardia, general weakness.
These symptoms make it difficult to make a diagnosis, which is why the patient is sometimes not provided with the urgent help necessary for an acute attack of glaucoma.
Measures to reduce intraocular pressure must be taken no later than several hours after the onset of an attack – this will help prevent irreversible loss of vision!
Pashinova Nadezhda Fedorovna
Chief physician of the Moscow ophthalmological clinic “Excimer”, ophthalmic surgeon of the highest category, Doctor of Medical Sciences, Associate Professor, Academician of the Russian Academy of Natural Sciences
“Patients often ask if they will see better after glaucoma surgery.In most cases, especially with very high eye pressure, this does not happen. But the purpose of the operation is not to improve vision, but to preserve it in general. According to statistics, 14-15% of all blind people in the world have lost their eyesight due to glaucoma.
We do not expect the vision to be as good as after replacing the lens. The main thing is to preserve the patient’s vision for many years and stop the progression of the disease. ”
Congenital glaucoma: Sintomas y tratamientos
Appropriate treatment at the first stage of congenital glaucoma can slow the progression of the disease, which is why early diagnosis is so important.For the treatment of this type of glaucoma, surgery is usually used, with the goal of eliminating the defect in the corner of the eye. If the operation is performed in a timely manner, children can restore their eyesight.
Initially, treatment with various eye drops and medications is usually prescribed to try to maintain intraocular pressure for subsequent surgery.
The appearance of the eye after trabeculectomy, there is a small blister in the upper part of the eye (arrow)
The method of surgical intervention depends on the condition of the cornea: if it remains transparent, then a goniotomy is performed, if I have already become dull, then trabeculectomy.Both methods are used to open the abnormal corner of the eye in order for it to function properly. If unsuccessful, other methods can be used, such as installing a drain valve.
In a trabeculectomy, a small piece of tissue is removed to open a new channel to drain the ocular fluid. Valves are plastic tubes that connect the outside and inside of the eye, and through which the ocular fluid is expelled. Only one eye can be operated at a time.The success rate of the operation is 60-80%, but over time, when the excretory canal is closed, new surgery may be required. After surgery, the patient is given eye drops to prevent inflammation or infections.
Tube inside the eye with congenital glaucoma after surgery with valve installation
What is the prognosis for the child’s vision recovery?
Restoration of vision in children with congenital glaucoma depends on many factors, for example:
- Time of diagnosis: The worst diagnosis is usually in newborns or children who have had high intraocular pressure for many months and have not been treated.
- Corneal injury: in this case, the patient may require, in addition to glaucoma surgery, also a corneal transplant.
However, with early diagnosis and appropriate treatment, the disease can be successfully controlled until adulthood.
How to correctly administer eye drops to a child?
Correct use of drugs prescribed by an ophthalmologist for the treatment of glaucoma improves the patient’s condition and reduces the risk of side effects.For the correct administration of eye drops, the following steps must be performed:
- Wash your hands.
- Turn the bottle over.
- Tilt the baby’s head back.
- While holding the bottle with one hand, bring it as close to your eye as possible without touching it.
- With the other hand, slightly pull the lower eyelid. A small pocket will open between the eyelid and the eyeball.
- Place one drop of the drug in the pocket. If the ophthalmologist has prescribed a dose of more than one drop, wait at least five minutes before dripping the second drop.
- Close your eye or lightly press your lower eyelid with your finger for at least one minute.
This helps to keep the drug in the eye, preventing it from draining through the tear duct and risking side effects.
What research is being done in the treatment of glaucoma?
New methods are currently being sought to detect, treat, and prevent vision loss in people with glaucoma. For example, research has uncovered genes that may help explain how glaucoma affects the eye.Research is also being conducted to find out more about which people are more likely to develop glaucoma, when to start treating people with high intraocular pressure, and which treatment should be used first.
90,000 Eye blepharitis treatment in Yekaterinburg
One of the most common inflammatory diseases of the organ of vision is blepharitis, which affects the edges of the eyelids. Most often, this disease is chronic and difficult to treat.
Depending on the degree of damage to the inflammatory process, the following types of blepharitis are distinguished:
– anterior marginal (the mildest degree of the disease, when only the edge of the eyelid is affected (the place where the eyelashes grow),
– posterior marginal (a more severe form of blepharitis, when the meibomian glands are involved in the inflammatory process and, in the event of the development of the disease, the conjunctiva and cornea).
Most often, these types of the disease accompany each other and the disease manifests itself in the form of inflammation of the eyelid throughout the entire thickness.
Causes of the disease
The appearance of blepharitis can be a consequence of pathological conditions of the body as a whole, for example, a lack of vitamins, anemia, infectious diseases, allergies and other conditions. Also, this disease can occur due to infection with fungi or bacteria of the organ of vision.
Astigmatism, dry eye syndrome and hyperopia also contribute to the development of blepharitis.
The main symptoms of eyelid blepharitis are:
– discomfort: itching and burning of the eyelids, photosensitivity and rapid eye fatigue,
– external manifestations can be: swelling of the eyelids, redness, peeling of the skin of the eyelids.
If at least one of the symptoms manifests itself, it is necessary to consult an ophthalmologist for a diagnosis and treatment.
In the “Glaz” Microsurgery Clinic named after academician S.N. Fedorov “you will be provided with a full range of services for the diagnosis of the disease, and upon confirmation of the diagnosis of blepharitis, an individual treatment program will be assigned
The main method for diagnosing blepharitis is a slit lamp examination (biomicroscopy), however, additional research methods may be prescribed to confirm the diagnosis or in case of suspicion of other eye diseases.
If the diagnosis is confirmed, the patient is expected to receive long-term treatment, which is based on the elimination of the cause of the disease.
The cost of consulting an ophthalmologist on inflammatory diseases
In the “Glaz” Microsurgery Clinic named after academician S.N. Fedorov “diagnostics is carried out using the latest generation equipment, which excludes the possibility of inaccurate research results, on the basis of which ophthalmologists select an individual program for the treatment of blepharitis, depending on its form, degree of damage and the cause of its appearance.
Regardless of the cause of the disease, thorough eyelid hygiene is essential for the treatment period. For this purpose, hygiene gels and lotions are prescribed. In addition, depending on the cause of blepharitis, drugs are prescribed in the form of drops or topical ointments, which will eliminate it.
During the treatment of blepharitis, it is necessary to undergo regular examinations by an ophthalmologist, who will monitor the course of treatment and its effectiveness.
In case of untimely or incorrect treatment, blepharitis easily turns into an acute and chronic form, so take responsibility for choosing a clinic and an ophthalmologist who will carry out the treatment.
In the “Glaz” Microsurgery Clinic named after academician S.N. Fedorov ”, top-class specialists will establish the cause of the disease, prescribe effective treatment and advise on how to properly hygiene the eyelids during the treatment of the disease.
The cost of consulting an ophthalmologist on inflammatory diseases
Glaucoma: Symptoms and Treatment
Glaucoma is a dangerous disease that can have dire consequences up to complete loss of vision.If you do not start the fight against glaucoma in time, then the loss of vision can become irreversible. In no case should the symptoms be ignored and the treatment of glaucoma should be started as soon as possible. The sooner the patient turns to specialists for help, the better for himself.
The use of folk remedies for glaucoma treatment is not only useless, but can be very dangerous!
Unfortunately, blindness is a frequent consequence of an unfair attitude towards the health of the eyes and the body as a whole.This is a very frightening fact for many people, because the loss of the ability to see the world around us is directly proportional to the loss of the usual and possible joys of life.
The most commonly diagnosed is open-angle glaucoma, a disease that occurs due to blockage of the drainage channel of the eye. With glaucoma, the intraocular pressure of the eye (IOP) increases, which leads to damage to the optic nerve. At the same time, vision is rapidly deteriorating. In order not to become blind, it is important not to postpone glaucoma treatment for a day.In addition, you do not need to try to draw up a course of dealing with the disease yourself. Chances to slow down the process of nerve dying are given only by correctly selected treatment, adherence to all recommendations of the attending physician and, if necessary, surgical intervention. It is alarming that recently glaucoma is getting younger, more and more often taking away vision from people in their prime. Patients over the age of forty are increasingly turning to clinics for an ophthalmologist’s consultation about developing glaucoma.In addition, this disease has congenital and adolescent forms.
Causes of glaucoma development
A healthy eye normally produces a special fluid every day that fills it. About 4 milliliters of fluid are produced per day. In the corner of the anterior chamber (between the cornea and the iris) of the eye, there is a drainage system through which fluid flows out of the eye. Normally, the eye pressure is 16 to 25 mm.mercury column. Increased pressure leads to intense compression of the fibers of the optic nerve and blood vessels, followed by the gradual death of the nerve and blindness.
The disease is terrible because it can be asymptomatic and cause irreversible deterioration of vision. The most common symptoms of glaucoma are blurred vision, iridescent circles when looking at bright light, redness, pain in the area of the eye and the corresponding half of the head.
Open-angle glaucoma : gradual loss of peripheral vision.Symptoms begin to appear only in the later stages of the disease. To identify it, you should use mass surveys.
Angle-closure glaucoma : severe bouts of pain in the eye, nausea and vomiting, blurred vision and the appearance of a rainbow halo around the light source, the cyclical course of the disease is also very characteristic – when periods of exacerbations alternate with intervals of imaginary well-being.
Symptoms that should alert
There are three groups of symptoms:
- common to all eye diseases,
- more characteristic of glaucoma,
- reliable early symptoms of glaucoma development.
The first group includes the “flashing of flies” before the eyes and excessively rapid eye fatigability during visual stress (primarily reading). These manifestations indicate that your eyes are in danger.
The second group includes the following symptoms.
- Periodic blurred vision. Surrounding objects at such moments are visible as through some kind of veil: from light haze to dense fog. This condition can last from several minutes to several hours and occurs intermittently, for no apparent reason.This is explained by corneal edema at moments of increased intraocular pressure.
- Rainbow circles. When you look at a light source, you suddenly see a dark space around it, which is limited by a “rainbow” circle: the closest to the light source is violet, the farthest is red, and in the gap all other colors of the spectrum are visible. True, the same iridescent circles are observed with conjunctivitis and initial clouding of the lens, but there are signs by which they can be distinguished. In conjunctivitis, the iridescent circles disappear immediately after the mucus is removed from the eye; with changes in the lens, on the contrary, the circles are constant.Circles caused by incipient glaucoma are transient and have nothing to do with the formation of mucus in the eye.
- Headache. With glaucoma, headaches most often resemble a migraine attack. With glaucoma of one eye in the initial stage of development, pain is quite typical: it appears in the temple area (on the side of the affected eye) and is spasmodic, often pulsating.
Two symptoms of the third group make it possible to suspect the initial stage of glaucoma with relatively high confidence.
- Lacrimation. This is one of the relatively reliable early symptoms of latent glaucoma.
- Apparent hydration of the eye. The symptom is manifested by the fact that the eye is filled with a tear; you take a handkerchief, wipe your eyes – but the handkerchief remains completely dry. There is no tear, and the feeling of hydration is associated with increased intraocular pressure. This is a very characteristic symptom of glaucoma – often it is its appearance that gives the patient himself the opportunity to suspect that he is developing glaucoma.
The most common manifestations of glaucoma at the earliest stage of its development are:
- intermittent blurred vision
- seeing rainbow circles around a light source
- eye pain
- flashing “flies” and rapid eye fatigue
Fragment of the program Live Healthy 09/09/2015 (simple test for glaucoma)
Diagnostics and methods of treatment of glaucoma
Special tests and actions will help doctors determine glaucoma:
- Tonometry – measurement of intraocular pressure.
- Perimetry is a study by which a patient’s field of vision is checked, for which the optic nerve is responsible.
- Ophthalmoscopy – a method aimed at examining the fundus and determining the state of the optic nerve.
- Optical coherence tomography – an objective way to determine the state of the optic nerve.
Based on the results of procedures and analyzes, the attending physician will prescribe the most appropriate and necessary treatment.
Today there are 3 treatment options to prevent further development of glaucoma:
- drug therapy
- laser treatment
- surgical treatment
Treatment of open-angle glaucoma by surgery helps to reduce intraocular pressure, which prevents further destruction of the optic nerve.
During the operation, doctors create a new pathway for the outflow of intraocular fluid. The most recent innovation in this type of treatment is called “non-penetrating deep sclerectomy (NHD)”. This type of surgery has significant advantages in comparison with earlier methods, and the most important of them, of course, is that during the operation, the membranes of the eye are not opened. Thus, the possibility of complications is almost completely excluded. NGSE is performed only under local anesthesia, therefore, it is cheaper, and the patient does not need a long period to recover from anesthesia.During a short-term operation (up to 20 minutes), an operating microscope, various microsurgical instruments with diamond or sapphire blades are used.
If, some time after the surgical intervention, the intraocular pressure exceeds 22 mm Hg, an additional laser procedure, Descemethogonipuncture, is necessary, which enhances the outflow of intraocular fluid.
Laser treatment for glaucoma is safe and effective.Depending on the type and stage of glaucoma, it may be recommended to carry out other types of antiglaucomatous operations: implantation of the Ahmed valve, drainage of the posterior chamber, deep sclerectomy, or the appointment of a combined treatment that combines surgery and medication.
Video from the program “Health with Elena Malysheva” about laser treatment of glaucoma.
Selective laser trabeculoplasty
The use of folk remedies for glaucoma treatment is not only useless, but can be very dangerous!
Patients often ask if there are folk remedies for glaucoma.Yes, among the people there are recipes for drugs that supposedly help in the treatment of this disease. However, the use of folk remedies for glaucoma treatment is not only useless, but can be very dangerous! The fact is that, being carried away by the so-called traditional medicine, patients often neglect the treatment that they really need, namely, medications prescribed by a doctor or recommended surgical interventions. And glaucoma does not forgive this! In the absence of the necessary treatment and qualified medical supervision, it can lead to irreversible blindness.Therefore, the only way to preserve vision in glaucoma is to regularly monitor the condition of the eye and intraocular pressure and take a set of measures aimed at its normalization in a timely manner.
If you are diagnosed with glaucoma or have a hereditary predisposition to this disease, do not hesitate and do not rely on traditional medicine! See your doctor urgently!
Chalazion of the century – treatment in the clinic Dr. Vizus
Causes of the onset and peculiarities of treatment of chalazion century
The chalazion of the century is the accumulation of the secretion of the meibomian gland in the movable part of the eyelid in the form of a rounded formation that is not welded to the surrounding tissues.The appearance of chalazion may be preceded by a weakening of the immune system, a chronic course of gastrointestinal diseases, inflammation of the edge of the eyelids.
At the initial stage, the disease does not cause any unpleasant sensations and is almost imperceptible visually. Over time, the formation increases in size, delivering an aesthetic inconvenience to a person, a secondary infection can join, edema and hyperemia of the eyelids can be observed. In some cases, a spontaneous opening of the chalazion occurs and a fistula is formed.
To exclude the occurrence of chalazion against the background of blepharitis or other diseases of the eyelids, it is necessary to strictly adhere to the doctor’s prescriptions and carry out the treatment in full.
Treatment of a mild eyelid chalazion consists in the local application of drugs based on antibiotics (drops, eye ointments) and physiotherapy procedures (UHF therapy, massage of a blocked gland, warm compresses). With a long-term illness and a large size of the chalazic capsule, a surgical method is used: under local anesthesia, a micro-incision of the skin or conjunctiva is made and the formation is removed.The procedure is performed on an outpatient basis and takes 15-25 minutes.
The prognosis for the treatment of the eyelid chalazion is favorable, relapses occur in rare cases.
Advantages of chalazion treatment at the Doctor Vizus clinic
Turning to the clinic “Doctor Visus”, you entrust your health to professional ophthalmologists with 25 years of experience, practicing eye surgeons and qualified specialists of the highest medical categories.
In our work, we use only the latest diagnostic, microsurgical and therapeutic equipment.
Surgical removal of chalazion using the SURGITRON radiosurgical device (USA) eliminates complications and does not require sutures and dressings.
For each patient, we develop an individual treatment plan for the eyelid chalazion, depending on the stage of the disease and the activity of the inflammatory process.If necessary, a convenient schedule of visits to the clinic for physiotherapy procedures is drawn up.
Doctor Visus Ophthalmology Center will help you quickly, effectively and safely get rid of the chalazion of the century
Make an appointment with an ophthalmologist at our clinic if a small white spot appears on the inner surface of the eyelid. Early diagnosis of chalazion and detection of the disease at the initial stage is a guarantee of effective treatment and quick rehabilitation without consequences.
“Doctor Visus” – high-quality medical care for ophthalmic diseases.
Call for an appointment for a consultation by calling the clinic:
8 (495) – 699 95 95
03/06/2019 Take care of your eyes!
March 6 is World Glaucoma Day. On the eve of the date, employees of the surgical department of the Tambov City Clinical Hospital No. 3, Tambov City Clinical Hospital, carried out a preventive action among the population.
Its goal is to draw the attention of the population to the problem of preserving vision, to form a responsible attitude to health. Experts called for a healthy lifestyle and tried to prove the need for regular preventive medical examinations by an ophthalmologist.
During the action, medical workers told about the disease, its symptoms and causes, preventive measures.
“It is extremely difficult to detect glaucoma at the initial stage without knowing the signs of this disease,” Valeria Alekseevna Popova, an ophthalmologist at the polyclinic, explained to the participants of the action.- Unfortunately, people often do not pay attention to its first manifestations or do not associate them with eye disease. Glaucoma, like any other disease, needs to be identified in a timely manner. Therefore, it is very important to be able to recognize its early signs. ”
Alarm signal – increased intraocular pressure. Its signs are: blurry vision; the appearance of a “grid”, “rainbow circles” before the eyes when looking at a bright light, for example, a light bulb; a feeling of discomfort, heaviness, tension in the eyes; slight pain; feeling of moisture; slight pain around the eyes; blurred vision at dusk.
Unfortunately, glaucoma is a fairly common disease that affects mainly people after 40 years of age. However, this disease can appear at a young age (adolescent glaucoma), even in infants (congenital glaucoma). With glaucoma, vision may decrease until complete blindness occurs.
Specialists told the participants of the action about who needs to undergo vision diagnostics in the first place.
First, patients over the age of 40.Secondly, those who had relatives with glaucoma in their family. Thirdly, it is worth paying close attention to myopic people on their health. They are more prone to glaucoma because their eye membranes are thin and glaucoma develops faster and more aggressively than others.
In addition, it is necessary to remember the simple rules of prevention:
1. Quit smoking: Smoking dramatically increases the risk of developing the disease.
2. Limit exposure to the sun: prolonged exposure to the sun increases intraocular pressure.
3. Stick to a diet that restricts fluid intake to 1.5 – 3 liters per day. Avoid salty, spicy and fatty foods. Eat more fruits, vegetables, and sea fish.
4. Avoid stressful situations, as stress can trigger disease.
5. Perform a daily light massage of the eyes, this improves blood circulation and helps to reduce intraocular pressure.
Our medical workers measured intraocular pressure to the participants of the action, showed them how to properly massage the eyes, and distributed leaflets and leaflets telling about measures to prevent glaucoma.
90,000 Open-angle glaucoma – causes and symptoms. Open-angle glaucoma treatment
The term “primary open-angle glaucoma” combines several clinical forms of the disease. All are characterized by an open angle of the anterior chamber, increased ophthalmotonus (with the exception of pseudonormal pressure glaucoma), glaucoma excavation of the optic nerve head, and pathognomonic disturbances in the visual fields.
Open-angle glaucoma: clinical forms and their causes
Open-angle primary glaucoma (POAG) occupies 70% of all glaucomatous diseases. In the 45-year-old age group, its prevalence is 1-2%, by the age of 60 – already 3-4%. This is a genetically determined pathology. And also in the risk group – elderly people, with diabetes mellitus, hypertension, myopia, early age-related hyperopia.
There are 4 clinical forms of POAG:
Simple – occurs against the background of dystrophic changes in the trabecular apparatus – the drainage system of the eye.The obstruction of the outflow of aqueous humor is accompanied by a lack of blood supply and ischemic disorders. Simple POAG is characterized by a relatively slow progression, the second eye is affected later and to a milder degree.
Patients turn to an ophthalmologist only at later stages due to the absence of symptoms of open-angle primary glaucoma in the initial period of the disease.
For pseudoexfoliative POAG, a more aggressive course with high numbers of hypertension is characteristic.The disease is bilateral, only in a quarter of patients it affects only one eye. The cause of glaucoma is amyloid-like deposits on the iris, lens, ciliary body and in the structures of the PC angle against the background of degenerative lesions of the trabecular filter. Pseudoexfoliation syndrome leads to damage not only of the hydrodynamic, but also of the vascular system of the eyeball, general vascular pathology, aggravating the course of the disease.
Pigment POAG develops due to the “clogging” of the drainage system with lumps of pigment.Granules from the disintegrating neuroepithelial layer of the iris are also deposited on the inner surface of the cornea, causing complaints of iridescent circles around light sources. This symptom of open-angle glaucoma – a pigmented form – is constant, in contrast to similar periodic complaints in a subacute attack of angle-closure glaucoma.
POAG with normal (pseudo-normal) IOP is a special form in which there is no one of the key signs – increased ophthalmotonus. At the same time, there are other signs of the glaucomatous process – characteristic visual field defects, atrophy of the Nervus opticus with excavation.They allow pathology as a variant of reduced adaptation of the optic nerve to the individual level of IOP – the so-called low level of tolerance. All patients have systemic hemodynamic disorders – vascular crises, spasms, nocturnal hypotension, etc.
Development stages and symptoms of open-angle glaucoma
The pathological process arises and develops in the initial stages unnoticed by the patient. It is possible to suspect a disease only on the basis of an increased IOP measured in the ophthalmologist’s office.
Subjective symptoms of open-angle glaucoma appear with the death of 30% of the optic nerve fibers.
Lost visual functions in glaucomatous pathology are not restored even with adequate therapy. This feature – imperceptible symptoms of open-angle primary glaucoma in the initial stages and irreparable loss of vision – makes the early diagnosis of glaucoma the most important task of clinical examination of persons over 40 years of age.
All forms of POAG develop sequentially and go through stages:
1. Initial. There are scotomas (loss of areas of the visual field) in the central sections, the peripheral borders are normal. When examining the fundus, the doctor notes the expansion of the excavation of the Nervus opticus. The patient is not worried about anything. Only people with professions or hobbies that require perfect vision can notice the first symptoms of open-angle primary glaucoma – interference in the center of the visual field.
2. Developed. There is a narrowing of the nasal border of the field of view by 10 or more degrees, excavation reaches the edge of the disc. The patient may not yet notice the symptoms of open-angle glaucoma.
3. Far gone. The perimetry determines the limitation of the view from all sides, the edge excavation is almost complete. At this stage, due to the “tubular” vision in a bilateral process, there are problems with orientation in space.Even at this stage, with a healthy second eye, the patient notices the problem by accident, covering the well-seeing eye.
4. Terminal. Visual functions are lost, sensations of light may persist, but the patient does not determine the direction of the source.
Thus, practically the only symptom of primary open-angle glaucoma – a gradual narrowing of the view – may not be noticed by the patient up to critical values, up to complete blindness.
In this sense, angle-closure glaucoma is more indicative, as it proceeds with seizures, in which the eye hurts, reddens and worries, which makes it necessary to consult a doctor and identify pathology.
To detect ocular glaucoma, an annual examination by an ophthalmologist of persons over 40 is required.
The mandatory list of studies includes:
determination of visual acuity without correction and with correction;
autorefraktokeratometry – computer determination of refraction;
tonometry (contact, according to Maklakov, or non-contact) – measurement of intraocular tone;
biomicroscopy – slit lamp examination;
ophthalmoscopy – examination of the fundus.
When determining ophthalmic hypertension, perimetry (examination of the visual fields), gonioscopy (study of the structures of the anterior chamber angle) and pachymetry (measurement of the thickness of the cornea) are additionally performed. On the basis of these examinations, a diagnosis is made, in doubtful cases, “Suspicion of glaucoma” is diagnosed and the indicators are monitored after 2-4 weeks.
To confirm or clarify the diagnosis, the glaucomatologist can prescribe tonography (determine the rate at which aqueous humor is formed and evacuated), daily tonomerism, stress tests, and optical coherence tomography (OCT) of the optic nerve.
They involve related specialists: a therapist and a neuropathologist to identify and correct common diseases.
Treatment of open-angle primary glaucoma
When a disease is detected, antihypertensive drops are prescribed. The first choice drug, in the absence of contraindications, is prostaglandins F-2a – Xalatan, Travatan, Prolatan or their analogues.
After 2 weeks, the drug effect is monitored, with insufficient action, the drug is changed or supplemented with a second of a different mechanism of action.These can be beta-blockers (Timolol, Betoptik, Proxodolol) or carbonic anhydrase inhibitors (Azopt, Dorzopt, Trusopt). Combined pharmaceuticals are also used – Ksalakom, Azarga, Dorzopt-Plus, etc.
Self-canceling or replacing drugs is unacceptable!
On the eve of the control IOP measurement, it is imperative to instill medical drops according to the prescribed scheme.If this condition is not met, it is impossible to evaluate the effectiveness of conservative treatment of open-angle primary glaucoma. The use of these drugs is constant, daily, according to the schedule recommended by the ophthalmologist.
Glaucoma treatment is complemented by courses of vascular therapy to improve blood supply and metabolic processes in the brain.
If ophthalmotonus persists against the background of the use of 2 or more drugs, surgical treatment of open-angle glaucoma is indicated.
Surgical treatment of open-angle glaucoma
Glaucoma operations are aimed at normalizing hydrodynamics and do not restore visual functions. Intervention for glaucoma is performed with a laser or scalpel at stages I-III. Their goal is to form artificially additional pathways for the outflow of aqueous humor.
Laser treatment of open-angle glaucoma – trabeculoplasty (LTP) and its type, selective LTP – improves the permeability of the trabecular apparatus for aqueous humor.This is the operation of choice, subject to compensation for hypertension and the absence of other contraindications.
Microsurgical treatment of open-angle glaucoma with fistulizing operations (non-penetrating deep sclerectomy, trabeculectomy, sinusotomy) allows you to direct part of the intraocular fluid under the conjunctiva.
Cyclodestructive interventions reduce the secretion of the ciliary body. These operations are usually performed for terminal painful glaucoma, since there is a high probability of severe hypotension and atrophy of the eyeball in the postoperative period.
Surgical treatment of open-angle glaucoma does not exclude a rise in pressure in the future due to fibrous degeneration in the intervention area. In most cases, even after a successful operation, laser or microsurgical, there remains the need for daily instillation of antihypertensive drops in a minimum dosage.
There is no prophylaxis for open-angle glaucoma to prevent the disease. Strictly observing the recommendations of the attending physician regarding the treatment of open-angle glaucoma and regular scheduled examinations, you can significantly slow down the development of the process.
Prices for services for glaucoma
|No.||Service name||Price in rubles||Appointment|
|2010025||Set of disposable consumables for antiglaucomatous surgery||36000||Sign up|
|2010024||Valve implantation Molteno||54000||Sign up|
|2010023||Implantation of valve EX-Pres shunt||54000||Sign up|
|2010022||Implantation of Ahmed valve||54000||Sign up|
|2010021||Suturing collagen or silicone drainage||9000||Sign up|
|2010018||Basal iridotomy||10800||Sign up|
|2010001||Sinutrabeculectomy (STE)||42000||Sign up|
|2010002||Non-penetrating deep sclerectomy (NGSE)||46200||Sign up|
|2010004||Antiglaucomatous surgery for primary glaucoma of the first category of complexity||23400||Sign up|
|2010005||Antiglaucomatous surgery for primary glaucoma of the second category of complexity||30600||Sign up|
|2010006||Antiglaucomatous surgery for primary glaucoma of the third category of complexity||37200||Sign up|
|2010007||Antiglaucomatous surgery for secondary or refractory glaucoma of the first category of complexity||29500||Sign up|
|2010008||Antiglaucomatous surgery for secondary or refractory glaucoma of the second category of complexity||42000||Sign up|
|2010009||Antiglaucomatous surgery for secondary or refractory glaucoma of the third category of complexity||48000||Sign up|
|2010010||Antiglaucomatous surgery with drainage of the anterior chamber angle in primary glaucoma of the first category of complexity||28200||Sign up|
|2010011||Antiglaucomatous surgery with drainage of the anterior chamber angle in primary glaucoma of the second category of complexity||39300||Sign up|
|2010012||Antiglaucomatous surgery with drainage of the anterior chamber angle in primary glaucoma of the third category of complexity||45600||Sign up|
|2010013||Antiglaucomatous surgery with drainage of the anterior chamber angle in secondary or refractory glaucoma of the first category of complexity||33360||Sign up|
|2010014||Antiglaucomatous surgery with drainage of the anterior chamber angle in secondary or refractory glaucoma of the second category of complexity||43800||Sign up|
|2010015||Antiglaucomatous surgery with drainage of the anterior chamber angle in secondary or refractory glaucoma of the third category of complexity||54000||Sign up|
|2010017||Reconstruction of the anterior chamber angle in secondary glaucoma||27000||Sign up|