How diagnosed and treated closure glaucoma ?

Glaucoma is translated from Greek means "blue" as the eye becomes light blue color as a result of chronically elevated intraocular pressure and optic nerve atrophy.

dangerous complication of glaucoma is blindness, which may occur without treatment of the disease.One form is the angle-closure glaucoma, which is rare and occurs because of the overlap of the outflow of aqueous humor through the angle of the anterior chamber of the eye.

Causes of angle-closure glaucoma

Unlike open-angle glaucoma, the angle of the anterior chamber is open, closed-form of glaucoma, this angle is blocked, whereby the disease is acute with the instantaneous increase in intraocular pressure.The incidence of this form of glaucoma is only 5-10% of all forms of the disease.

Very often, this condition develops when an existing farsightedness in people whose age is over 30 years old.In these patients the eye cavity of small size creates all conditions for the occurrence of violations of the outflow of intraocular fluid.These inc

lude the shallow anterior chamber, as well as a shift of anatomical structures of the eye forward.With age, these symptoms are exacerbated by the structure of the lens increases and the reduction of anterior chamber due to increasing farsightedness.

By the nature of the flow angle-closure glaucoma is an acute, subacute and chronic course.Especially dangerous are acute and subacute states that no medical emergency cause momentary loss of vision.

The causes and predisposing factors that may lead to the closure glaucoma include:

  • Features Eye structure and size of the ocular cavity.
  • farsightedness.
  • Mechanical damage and eye injury.
  • Frequent stressful situations and nervous stress.
  • Eye fatigue and exhaustion while working with a dim light.
  • Taking certain medicines groups (tranquilizers).
  • hereditary factor.

diagnosis is not difficult, as the disease begins acutely with sudden headaches, pain in the eye and other symptoms.The following methods of inspection are used for differential diagnosis:

  • Oftalmotonometriya - measured pressure in the eyes.It can be carried out with or without a load.
  • ophthalmoscopy - with the help of this method is determined by the degree of damage to the optic nerve.
  • Gonioscopy - in which the degree of overlap is determined by the angle of the anterior chamber of the eye.

According to the testimony and the general condition can be applied and other research methods (optical coherence tomography).

Symptoms of angle-closure glaucoma

During an attack of the clinical picture is bright, and the signs of the disease are expressed.Symptoms of angle-closure glaucoma following:

  • sharp deterioration of vision and the narrowing field (peripheral).
  • Headaches (in the eyebrows and sideburns), and dizziness.
  • Pain in the eyes of varying intensity, until the sharp and throbbing.
  • nausea and possible vomiting.
  • eye redness and swelling of the growing age.
  • Tearing.
  • dilation of the pupil, which is not narrowed even in bright light.
  • intolerance and increased sensitivity to bright light.
  • fuzzy vision and motion blur.
  • appearance of bright circles around the existing light sources.

In some cases, signs of glaucoma may be mistaken for symptoms of poisoning, so it is very important to make a differential diagnosis of the disease.When the symptoms expressed by the patient should be immediately admitted to the hospital and have a medical emergency.Failure to provide help for a few hours during an attack may result in loss of vision.

methods of treatment and therapy

First aid for glaucoma is in the hospital and aims to reduce intraocular pressure and restoring outflow of intraocular fluid.For this purpose, inside and as local therapy applied following medications:

  • pilocarpine solution which is instilled in the eye every quarter hour at 1 -2 drops within one hour.Upon improvement of droplet state in angle-closure glaucoma is dropped every 30 minutes (over 4-5 hours), and then every hour, and then transferred to 6-7 times a day every 3 hour.
  • Inside diakarb taken at a dose of 0.25-0.5 2 times a day, which is a diuretic and reduces puffiness in the eye.To increase the reduction of intraocular fluid by the intramuscular or intravenous furosemide, which is also a diuretic.
  • Eyedrops containing therein a beta-blockers (for controlling intraocular pressure).


If conservative therapy does not render its action and the pressure is not reduced, resorting to operative treatment methods.Between closure glaucoma attacks treatment shown topical application of drops which reduce intraocular pressure (timolol, pilocarpine, dorzolamide, etc.).

operation with angle-closure glaucoma can be carried out with the help of laser surgery or conventional eye microsurgery.pressure correction method using the operations is selected depending on the patient's condition, presence of concomitant diseases, and severity of the disease.

Treatment of angle-closure glaucoma with a laser can be:

  • Lazernayairidektomiya - in which a laser creates an artificial drainage through the holes in the root of the iris.Presence of holes helps maintain pressure in the normal range and improves the flow of liquid.
  • Gonioplastika - in which the expanding angle between the iris and the cornea.In the region of the root of the iris make laser cauterization, which leads to some reduction (shrink), and allows tissue to expand the anterior chamber angle.

Microsurgical methods for treating the following:

  • Surgical iridectomy - in which the excised portion of the iris, and thus ensures the outflow of intraocular fluid.
  • operations with the creation of fistulas - which act as additional ways of outflow of fluid from the anterior chamber into the subconjunctival space.
  • operations on ciliary body (the destruction of the ciliary body) - in which the burning is conducted cilia ciliary body, which can significantly reduce the production of intraocular fluid.

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