Glaucoma factor: cannot be cured, can be controlled
[ad_1]
At the end of March, World Glaucoma Week is held – a disease that doctors call the silent thief of vision. For a long time it is asymptomatic, and it is often detected when the disease has already entered an advanced stage.
In the world, and in Russia in particular, glaucoma occupies a leading position among the causes of incurable blindness and is a very important medical and social problem. The number of glaucoma patients is constantly growing, which is also due to the aging of the population – after all, the risk of the disease increases with age.
Until now, glaucoma is an incurable disease, but its course can be significantly slowed down. Experts spoke about what is required for this during the Week.
Find in time
According to the World Health Organization, there are 2.2 billion visually impaired people in the world, and about 1 billion of them could be cured, and their vision loss could be prevented or eliminated. And if glaucoma (one of the main causes of irreversible blindness in the world) is detected and treated in time, its course can be significantly slowed down.
…According to expert forecasts, in 2030 in Asia the number of patients suffering from glaucoma may reach 50 million, in the US – 13 million, in the EU – 8 million. “Glaucoma is a disease that affects not only adults. For example, it can be congenital, both infants and adolescents suffer from it, ”says the head of the ophthalmological department of the Federal Medical and Biomedical Center named after. Burnazyan Svetlana Kopkova.
Glaucoma is a multifactorial disease that leads to damage to the optic nerve and is accompanied by a progressive narrowing of the visual fields, up to complete blindness. As a rule, intraocular pressure increases with glaucoma, but not always. “Most often, central vision in this disease remains intact for a long time, that is, the patient can see well into the distance. First of all, peripheral vision suffers. In the initial stages, patients do not immediately notice a narrowing of the field of view: this may be the loss of some specific areas or the appearance of dark spots. And only at a more developed and far advanced stage does a narrowing of the peripheral field of vision appear. In addition, when looking with both eyes, the patient may not notice that one eye sees much worse than the other, ”says Dr. Kopkova.
However, there are risk factors for glaucoma that you should pay attention to: the presence of glaucoma in immediate family; a history of cardiovascular disease; myopia; taking steroid drugs. There are some symptoms that may indicate the presence of glaucoma: soreness or a feeling of sand in the eyes; periodic appearance of a veil or interference before the eyes, the appearance of luminous halos around light sources or when driving a car; blurred vision at dusk; headache. “Angle-closure glaucoma manifests itself more clearly, such patients turn to their doctor faster. With open-angle glaucoma, these symptoms can be blurred and do not always force patients to turn to an ophthalmologist in time, ”continues Svetlana Kopkova.
And although the main indicator of the development of glaucoma is increased intraocular pressure, in some patients it may be higher or lower than normal, for example, due to the individual thickness of the cornea. In addition, glaucoma of normal intraocular pressure is isolated (most often it is diagnosed in women with hypotension or migraines). Therefore, to establish a diagnosis, it is important to conduct a comprehensive examination, including perimetry (measurement of visual fields) and ophthalmoscopy (examination of the fundus and optic nerve). In addition, optical coherence tomography is an effective diagnostic method.
Heal and don’t give up
Glaucoma cannot be completely cured, but it can be controlled. Treatment of glaucoma consists of several areas: medication (eye drops; drugs that reduce the production of intraocular fluid or its outflow, as well as drugs that perform both of these functions at the same time), laser techniques, and surgical treatment. At the same time, at any stage, a patient with glaucoma also needs neuroprotective treatment, for which drugs are prescribed to improve cerebral blood supply.
According to Ivan Shchukin, Associate Professor of the Department of Neurology and Neurosurgery at the Pirogov Russian National Research Medical University, the eye is part of the brain, and glaucoma is caused by the same mechanisms as neurodegenerative diseases: “The eye is a mirror of the brain, on the basis of which and in the analysis of which we we can judge very many processes that occur in the central nervous system. Neurological (such as vascular diseases of the brain, including stroke, cerebrovascular insufficiency, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease) and neuro-ophthalmological diseases share the same causes and mechanisms of development. For example, very often Alzheimer’s disease begins with glaucoma. The same mechanisms cause both brain damage and retinal damage. Infections, stress, intoxication, genetic characteristics and a huge range of factors about which we know practically nothing lead to inflammation and impaired vascular permeability, to damage to the microvasculature. As a result, a cascade of cellular reactions is triggered, leading to neuroinflammation, which leads to damage and death of brain cells – neurons (neurodegeneration). Progressive neurodegeneration of the optic nerve and death of retinal ganglion cells in glaucoma are the leading cause of irreversible vision loss. Therefore, patients need cell protection – neuroprotection, which can be drug-induced and non-drug. That is, special drugs with direct and indirect neuroprotective effects and a healthy lifestyle.”
If a patient with glaucoma is treated on time and he follows all the doctor’s recommendations, then the effectiveness of drug therapy in 80% of patients allows maintaining good vision for many years. True, 10% of patients who even received treatment and were observed by an ophthalmologist, unfortunately, still go blind. At the same time, according to doctors’ statistics, 50% of patients with glaucoma do not follow the doctor’s recommendations, that is, they do not follow the drug therapy regimen. Some drop out of treatment because they don’t see the effect (although it’s basically impossible to see it); some suffer from side effects (drugs with preservatives often cause dry, red, or inflamed eyes). Doctors consider generic eye preparations that have flooded our market and the quality of which no one guarantees to be a separate problem, since they do not undergo separate clinical trials.
…Doctors advise healthy people over 40 to visit an ophthalmologist once a year and measure intraocular pressure. People at risk need such an examination twice a year after 35 years. Patients with an established diagnosis are reminded not to violate the regimen of taking medications and visiting a doctor. In addition, such people are recommended to limit (or better, completely exclude) working with a computer, reading books and watching TV. Ceiling lighting is more suitable for them, and being upside down for a long time (for example, to perform garden work) is dangerous for them. It is important for patients with glaucoma to get enough vitamins of groups A and B.
“Glaucoma is an insidious disease. We urge both patients and their relatives to take the diagnosis seriously and carry out the treatment prescribed by the ophthalmologist strictly according to plan. If glaucoma is detected in the early stages, the disease can be slowed down and the development of blindness prevented. Unfortunately, most patients come to the ophthalmologist at advanced, and sometimes far advanced stages, and they have to fight so that the eye does not go blind, ”says the expert.
Newspaper headline:
Silent thief of sight
[ad_2]
Source link
