How cataract and glaucoma are manifested and how to cure ailment

1 Cataract characteristics

Cataract is a gradually developing clouding of the lens. The lens loses transparency and the ability to refract light. This disease develops most often in old age, as a result of degenerative processes in the lens, accompanying aging. The most common causes of cataracts:

1. Secondary cataract, which develops after injuries, surgeries, eye diseases.
2. Congenital cataract.

Hereditary predisposition, diabetes mellitus and other metabolic diseases, ultraviolet, x-ray or radiation exposure, intoxications( including medicinal ones), high-grade myopia, glaucoma may be factors contributing to the development of lens opacity.

The disease progresses slowly, over the years, so the first signs of cataracts often go unnoticed. The most important symptom is a progressive decrease in visual acuity. If the patient previously wore glasses, he begins to notice that their shift is required more often than before. Appears sensitivity to bright light, but at the same time the need for additional lighting. Color perception also becomes worse, vision does not seem clear even with correctly selected glasses. Two simple tests for the presence of cataracts: if one eye is closed, then the objects around seem bifurcated, and if you look at any light source, you can see a halo around it.

Stages of cataract development:

• initial - clouding of the marginal zone of the lens without damage to the optical;
• immature - turbidity spreads to the optical zone, the first symptoms appear;
• is mature - clouding the entire area of ​​the lens, it is opaque, there is a loss of vision, with a timely operation, it is reversible;
• is overripe - the dissolution of the lens cortex, at this stage, the most serious complication of cataracts is the rupture of the lens capsule and the release of its contents into the cavity of the eye with the development of endophthalmitis.

Diagnostic measures to establish a diagnosis of cataract include routine methods - determination of visual acuity, visual fields and degree of binocular vision, measurement of intraocular pressure, examination of the eye with a slit lamp. And additional, used to clarify the degree of cataract, - refractometry, ophthalmometry, skiascopia.

2 Medical measures

Drug treatment can significantly slow down the development of the disease. It is carried out in the early stages, when the patient's vision is sufficiently secure. Eye drops with ascorbic acid, glutamine, cysteine ​​are used, but they are not effective enough. The only way to completely cure cataracts remains surgical treatment.

The operation is performed at any stage of cataract maturity, an indication to it is loss of vision leading to a decrease in ability to work. The essence of the operation is to remove the clouded lens and install an intraocular lens instead. Types of intraocular lenses:

1. Anteroposterior. Currently, they are rarely used, since they come into contact with very sensitive structures of the eye and often cause synechia( adhesions).
2. Rear-chamber. Installed in a capsule of the lens, if it is not removed during surgery. Provides the greatest visual acuity and distinction between the anterior and posterior chambers of the eye.
3. Pupillary. They are installed in the pupillary lumen. There is a big risk of dislocation of supporting elements.

The removal of the lens is possible with or without a capsule, it depends on the condition of the lens.

3 Etiology of glaucoma disease

Glaucoma is a group of diseases associated with increased intraocular pressure, disc detachment of the optic nerve and retina, narrowing of the field of vision. Glaucoma is caused by diseases associated with increased intraocular pressure, impaired circulation of tear fluid, trauma and surgery with the eye. It can occur simultaneously with cataracts.

There are 2 main types of glaucoma: open-angle( with a normal outflow of tear fluid) and zakratougolnaya( with a blockade of the iridocorneal angle and a violation of outflow of tear fluid).

In open-angle glaucoma, a small enlargement of the blind spot occurs in the initial stage, the second( developed) symptoms of glaucoma are manifested in the narrowing of the visual field from the nose( nasal narrowing) or circumference( concentric narrowing), its width does not exceed 15º.A stronger narrowing of the field of vision indicates a third, far-reaching stage, and the fourth( terminal) stage is characterized by complete or almost total loss of vision. Perhaps color perception, residual vision from the outside of the eye.

Closed-angle glaucoma occurs when disturbed outflow of watery moisture. This can contribute to the anatomical features of the eye, hyperopia, inflammatory diseases of the eye.

Acute attack of glaucoma is caused by a sharp increase in intraocular pressure.

It can be provoked by prolonged exposure in the dark, a large amount of drunk fluids, some eye drops, physical or emotional stress. During the attack, there is pain and a feeling of bursting in the eye, a sharp deterioration in vision, rainbow circles in front of the eyes when looking at the light source, redness of the eye.

Some of these glaucoma symptoms may also be present outside the attack( eg, pain or iris).

To measure the visual acuity and latitude of peripheral vision. Measurement of intraocular pressure may not be a diagnostic criterion, since there is a form of glaucoma with normal IOP.An ophthalmoscopy( examination of the fundus) is mandatory, which shows excavation( elevation above the retina) of the optic nerve disk, retinal detachment, turbidity of the internal environment of the eye. Before ophthalmoscopy, eye drops with atropine are used to dilate the pupil.

4 Therapeutic methods for the treatment of

pathology Like cataract, glaucoma can not be cured completely, but its development can be slowed down. From medical methods, eye drops are used, containing:

• preparations of prostaglandins and myotics( improve the outflow of watery moisture);
• β-adrenoblockers and inhibitors of carbonic anhydrase( reduce the production of aqueous humor);
• antihypertensive eye drops;
• neuroprotectors.

In case of acute attack of glaucoma, Pilocarpine and Timolol drops are used, painkillers( non-narcotic and narcotic) drugs intramuscularly, Lasix and Diacarb inside or intramuscularly.

Operative treatment of glaucoma is performed to improve the outflow of intraocular fluid. It can be carried out in several variants: iridectomy( creation of an artificial aperture in the iris), sinustrabeculectomy( creating an additional pathway of fluid outflow under the conjunctiva), iridocyclotretraction( widening of the anterior chamber angle of the eye).

Prevention of glaucoma and cataracts is the regular examination of an ophthalmologist, especially when there are several risk factors at the same time. It is important to observe the regime of work and rest, visual gymnastics is useful. But to prevent the development of cataract and glaucoma, as well as completely cure them, unfortunately, it is impossible.