Glaucoma, colloquially known as glaucoma, occurs when the optic nerve is damaged by a variety of causes. This is accompanied by defects in the field of vision. Furthermore, the intraocular pressure is enormously increased. There are different forms of glaucoma, such as B. the open-angle glaucoma, the normal pressure glaucoma, the secondary glaucoma or the narrow-angle glaucoma, with which this article deals increasingly.

Angle-closure glaucoma manifests itself in the fact that the chamber angle is narrowed and thus the resistance of the draining eye fluid increases. Since the Regenborg skin is more curved than normal in this disease, it also impedes drainage. The chamber angle is narrowed, especially in the dark, because the pupil is dilated. Therefore, an enormous increase in intraocular pressure (glaucoma attack) can occur, especially at night, which must be treated by an emergency doctor.

causes

There is no specific cause that leads to glaucoma. In principle, however, it should be stated that an increased intraocular pressure is related to this. Furthermore, the optic nerve is not supplied with enough blood. This undersupply can also promote the development of glaucoma.

Our eyes need eyewash to ensure all functions for normal vision . This eye fluid is produced but cannot drain normally in angle-closure glaucoma. This creates a pressure that constantly acts on the optic nerve. This pressure constricts the nerve, ultimately leading to impaired vision.

Other causes that favor an illness are nearsightedness or farsightedness , low blood pressure , metabolic diseases , old age, a thin cornea or hereditary factors.

Symptoms, Ailments & Signs

As already mentioned, the intraocular pressure can sometimes only increase to a critical level at night, which is why the disease can therefore go undetected by an ophthalmologist. Therefore there are no symptoms.

If symptoms such as visual disturbances or failures in normal vision are observed, the disease is usually advanced. Complete regeneration is now no longer possible because the optic nerve has already been damaged. Nevertheless, an ophthalmologist should definitely be consulted in order to curb the progression of glaucoma. Without this procedure, the patient goes blind.

In an acute attack, severe pain suddenly occurs in one eye and the corresponding side of the head i. V. m. Nausea and vomiting . It is an angle block. The aqueous humor in the eye can no longer drain. Intraocular pressure values ​​of up to 70 mmHg can occur. Therefore, action must be taken quickly to prevent blindness.

This is often associated with a hard eyeball and the perception of veils or rings in light sources. Some patients also speak of “constant foggy vision” or blurred vision .

Even in babies, congenital glaucoma can lead to damage and even complete blindness . Therefore, an examination should be carried out immediately in newborns of glaucoma patients who are already ill in order to rule out damage or to be able to treat it immediately. If an adult is diagnosed with congenital glaucoma, this is often reflected in a cloudy cornea, increased sensitivity to light or constantly watery eyes . Surgery is the only way to get better.

complications

Due to the often late detection of the disease, it can progress if left untreated. Thus, irreparable damage to the optic nerve may already have developed. If the disease is already very advanced, an operation may be necessary to preserve sight. An artificially produced drainage channel must be created in the eye.

Complications can occur at any time in connection with an operation, such as infections , bleeding , wound healing disorders , problems with anesthesia, etc. In the special case of an eye operation, bleeding or painful inflammation in the eye can occur, which leads to irritated and swollen eyes .

The laser methodology is also used to treat glaucoma. However, this is not a permanent solution. Since this treatment has to be carried out again and again, scarring and inflammation can form.

If the disease is not diagnosed in an advanced stage, it is usually treated with the help of eye drops. These drops must be administered for life. Alpha agonists or prostaglandins are often used for this. These drugs are effective in lowering the pressure inside the eye. There are no known complications associated with this treatment method, with the exception of slightly burning eyes when the drops are applied. There have been isolated reports of mild allergic reactions to ingredients or preservatives.

When should you go to the doctor?

Anyone suffering from declining eyesight should definitely see an ophthalmologist . However, this is not only recommended for older people. If you continue to feel a change in vision, such as B. blurred vision, “bent” edges, holes or black spots in the picture or constant flashes, a specialist should be consulted immediately. If no medical treatment is sought, this disease leads to blindness.

Another sign of angle-closure glaucoma is constant headaches or sore eyes. If this pain is observed over several days, a doctor’s visit should also be planned. If nausea and vomiting also occur and the eyes are red , these are also signs of an illness.

If there is already an illness in the family in this regard, other family members should take regular check-ups to determine the eye pressure. Every person over the age of 40 should also have an ophthalmological check-up carried out, as the risk of contracting the disease increases with age. Even small changes can be noticed that would go unnoticed in normal everyday life.

Diagnose

In the rarest of cases, narrow-angle glaucoma itself is diagnosed due to pain or the like. The disease is noticed by a thorough optometrist or ophthalmologist. These have devices for measuring eye pressure. If high intraocular pressure is measured, this is already a sign of glaucoma. An intraocular pressure of 21 mmHg or more is considered critical and leads to further examinations.

Therefore, the ophthalmologist will examine the field of vision to identify other limitations. The back of the eye is also examined with an ophthalmoscope. There will be an enlarged cavity (cup) where the optic nerve exits. Depending on how deep and how extensive this cavity is, it is possible to estimate the extent to which the optic nerve has been damaged.

Lasers are also used to accurately measure the optic nerve as a whole. The HRT (Heidelberg Retina Tomograph) will be used for this. The thickness of the cornea is determined by corneal pachymetry. To determine the strength of the nerve fibers in the immediate vicinity of the optic nerve, OCT ( optical coherence tomography ) or GDx ( laser polarimetry ) can be used.

The use of these procedures will reveal whether or not actual glaucoma is present. Anyone who is sent for such an examination by the ophthalmologist on suspicion of an existing disease for the purpose of a clear diagnosis does not have to reimburse any costs. Otherwise, these examinations are usually not included in the statutory health insurance service.

Treatment & Therapy

If glaucoma is recognized as such, immediate treatment should be given. If the disease is in an early stage, no massive interventions will be necessary.

A treatment with eye drops will take place first. Drops with the active ingredients of prostaglandins, cholinergics or beta blockers are used. Drugs of this type are intended to reduce the internal pressure in the eye, facilitate the drainage of aqueous humor and increase the transparency of the ciliary body. A combination of different active ingredients is also possible. If the glaucoma does not stop or even worsens, laser therapy as a surgical procedure may be necessary. In the beginning, however, it is usually sufficient to simply drip several times a day.

If an operation is unavoidable, the passage of the aqueous humor is often optimized with a laser in narrow-angle glaucoma. This improves the flow of aqueous humor between the chambers of the eye. Other treatments involve obliterating the ciliary body or using argon laser trabeculoplasty, which also improves aqueous humor flow.

Iridectomy is another way to preserve and improve vision. A small laser procedure is performed on the conjunctiva, the dermis and the ciliary body. Cataract surgery, in which the iris is treated, is also used to lower the intraocular pressure.

Outlook & Forecast

If the diagnosis “narrow-angle glaucoma” is available, this can be quite a shock at first. However, there are good prospects for a life without restrictions. This disease cannot be cured. Nevertheless, immediate ophthalmological treatment can determine exactly what stage of the disease the patient is in. If appropriate treatment is then started, the glaucoma can be stopped. Eyesight can be preserved.

However, if glaucoma is not treated, it will inevitably lead to blindness. The same applies to a glaucoma attack, which was explained above. If there is no immediate medical treatment here either, the patient loses his sight in this eye.

prevention

There is no direct possibility of prophylaxis in this area. It is important that everyone sharpens their perception and reacts immediately to changes in vision. “Early detection preserves eyesight” applies here!

Anyone suffering from diabetes or circulatory disorders should make regular appointments with an ophthalmologist. In this way, the intraocular pressure and the general condition of the eyes can be constantly monitored. Likewise, people whose relatives already have known glaucoma diseases should see a specialist regularly.

aftercare

Angle-closure glaucoma should always be treated by a doctor first. In most cases, the options for aftercare are severely limited, so that the person concerned is primarily dependent on the removal of the disease in order to prevent further complications and symptoms. The earlier the disease is detected, the better the further course of this disease is usually.

In most cases, narrow-angle glaucoma can be treated relatively well with the help of eye drops or other medications. There are no particular complications, although the person concerned should pay attention to the correct dosage.

Furthermore, surgical interventions are often necessary to relieve the symptoms permanently. The patient should definitely rest after such an operation and take care of the entire body, especially the eyes. Even after a successful procedure, regular check-ups are very useful. In most cases, the life expectancy of those affected does not decrease as a result of this disease.

You can do that yourself

Independent treatment of this disease is not possible. Therefore, each patient should regularly attend all proposed examinations. In this way, progression of the disease can be detected immediately.

Anyone who was diagnosed with narrow-angle glaucoma at an early stage should definitely use the prescribed eye drops regularly and at the exact time interval. In addition, everyone affected should pay attention to a healthy lifestyle. This includes regular exercise, good eye care and a healthy diet.

Accordingly, nicotine or excessive alcohol consumption should be avoided, as these poison the organism unnecessarily. Instead, cleansing and detoxifying foods should be consumed. This includes fruits, vegetables and sprouts. Therapeutic fasting also brings relief to some patients. Attempts should also be made to reduce stressful situations to a minimum.

In addition, the strain on the eyes must be taken into account and – if possible – reduced. Targeted eye training can be carried out. This provides relief and improves the psychological condition of those affected. Here’s an exercise: stretch your arm out with your thumb up, while moving your arm in different directions, watch your thumb, but don’t turn your head. As an affected person, everyone can do a variety of things to be able to lead a fulfilling and fulfilling life despite the illness!