Glaucoma। Doctors Gang Opthalmology

Glaucoma 

Introduction of glaucoma  

Unbeknownst to the patient, the range of his vision becomes concentrated as he erodes. The patient may see clearly from a great distance, but it is like looking through a circular tube. Can't see things around. It is difficult to drive. The symptoms are not noticeable, so, it is too late to be caught. The cause of the disease is damage to the optic nerve. The cause of the damage is the intraocular pressure inside the eye. The fluid inside the eyeball is called aqueous humor. When a certain level of pressure is applied to the optic nerve, the vision is damaged. When the patient senses, the damage is great. When the vision decreases, the patient sees blurred vision, then it should be understood that the central vision has also started to be damaged.

Symptoms of Glaucoma  

  • In the case of any particular glaucoma, the eyes become very blurred and 
  • there are symptoms such as pain or redness in the eyes. 
  • Glaucoma can also be a symptom of frequent changes of power within a very short period. 
  • It has been observed in many cases, people with more than minus power in the eyes, type 2 diabetes, eye injuries, thyroid, migraine, glaucoma in the family, being overweight, taking steroids for a long time The fear is high. 

Dr Maria said about the method of diagnosis, First, the patient's eye pressure or intra ocular pressure(IOP) is checked. After seeing the IOP, the inner corner of the eye or angle of the anterior chamber is examined through gonioscopy.

Two types of glaucoma

  This divides glaucoma into open angle or closed angle glaucoma.
Fluid pathway in Open Angle glaucoma

If it is open angle, it should be understood that the pressure of aquas humor has increased inside the eye, but the way for fluid to come out is open. This path is closed in case of closed angle.
Fluid pathway in closure angel glaucoma

The eyes often get sore, red and have to change the power of the glasses as a result of frequent rubbing. After looking at the angle, it is seen how much damage has been done to the nerve of the eye. In automated perimeters, it is possible to determine how much vision has lost. OCT or optical coherence tonography is performed if it is never caught in the perimeter or for confirmation. In many cases, damage to the optic nerve can occur even if IOP or intraocular
 pressure is normal or low. In all these cases, the disease cannot be detected without automated perimeter or OCT. 

Management of glaucoma  

Noman Islam Nirob  said, "Earlier the disease is diagnosis, the faster the damage can be prevented". As long as the vision has lost. It does not come back, but the remaining vision can be preserved. In this method, the doctor gives only the prescription, the rest depends on the caution of the patient, and his family. As soon as the medicine is administered in accordance with the rules, eye examinations should be done at regular intervals. Only then can glaucoma be prevented. ”

Complications of glaucoma  

1. Papiliodema
2. Blindness 

Laser Treatment for Glaucoma

Some glaucoma cases can be treated with medicine. but Most of the cases of Glaucoma need Laser Surgery or traditional surgery due to lower eye pressure. Common surgeries include:

1)Laser Peripheral Iridotomy – 

It's for patients with narrow-angle glaucoma. A small hole is made in the iris to Raise the angle between the iris and cornea of eye and encourage fluid drainage from the angle of the eye.

2.Argon Laser Trabeculoplasty and Selective Laser Trabeculoplasty – 

It is for patients with primary open angle glaucoma Cases. The trabecular passages are opened to increase fluid drainage.Argon laser Trabeculoplasty is effective in about 75% of glaucoma patients, and selective Laser Trabeculoplasty may be repeated cases.

3. Nd: YAG Laser Cyclophotocoagulation–

 it is for patients with severe glaucoma damage who have not been helped with any other surgeries. The ciliary body of the eye that produces intraocular fluid is destroyed.


4.Filtering Microsurgery/Trabeculectomy–

 it is for patients who have not been cured with laser surgical treatment or medications. A new drainage passage is made by creating a small hole in the sclera and creating a collection pouch between the sclera and conjunctiva of the eye.


5.Tube Shunt Surgery –

It May be recommended for patients who have neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue in previous surgery. A flexible, thin tube with a silicone pouch is inserted in the eye to clear drainage system.

Author : 
Noman Islam Nirob 
MBBS,Rangpur Medical College 

1 comment:

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