Glaucoma
Normal vision 
Vision with glaucoma
Glaucoma is a severe disease which often leads to blindness. When having glaucoma, intraocular pressure is getting high, damage occurs to the optic nerve and visual acuity and field of vision are decreasing (up to blindness). Blindness caused by glaucoma is irreversible for optic nerve is destroyed.
The only way to prevent blindness in case of glaucoma is early detection and proper treatment. The earlier it is detected, the easier and more effective is the treatment.
Due to modern methods of diagnostics and treatment, surgeons in Fyodorov’s Clinic are able to keep eyesight and joy of life to the most of our patients.
Causes of Glaucoma
Normally there is always a special ocular fluid produced inside the eye. It washes and nourishes the intraocular lens, cornea, vitreous body. After giving the nutritious elements and oxygen, it also carries away the waste products of metabolism.
Balance between the amount of liquid produced inside the eye, and liquid that drains out provides a constant value of Intraocular Pressure (IP). Normal values of Intraocular Pressure are individual, but average values vary from 15 to 25 mmHg of mercury.
2 main reasons for high intraocular pressure:
- Too much of intraocular fluid is produced;
- Intraocular fluid doesn’t drain properly through the drainage system of the eye, as a result of system changes.
In consequence of high intraocular pressure blood supply of the optic nerve is disturbed. Optic nerve atrophies if stays in such condition too long, and eyesight becomes worse.
Very important role in glaucoma initiation is played by heredity. If anyone of your relatives suffered glaucoma, you should be very attentive, and visit your ophthalmologist regularly. Examination and checking intraocular pressure and field of vision by ophthalmologist, not less than once a year, will help you to detect and efficiently treat glaucoma in time.
Symptoms and types of glaucoma
Open angle glaucoma is the most common type, when angle of the anterior chamber is open, but intraocular fluid is still handicapped, as a result of vascular and drainage ocular systems dysfunctions.
Signs of rising intraocular pressure:
- Foggy vision, vision of "grid";
- Rainbow-coloured rings when looking at lights (lamp for example);
- Discomfort in the eye: sense of heaviness and tension;
- Vision in the evening time is worsening.
Unfortunately, in most cases, this type of glaucoma develops unnoticeably, and is detected accidentally, when vision is already hardly impaired.
Closed-angle glaucoma is characterized by disturbance of intraocular fluid drainage for the drainage system of the eye is shut by iris. This type of glaucoma often is taking its course in a series of attacks. Acute attack of such glaucoma has certain symptoms: intraocular pressure significantly rises (up to 60-80 mmHg of mercury), severe pain in the eye, headache. Nausea, vomiting, and overall weakness might happen during glaucoma attack. Vision in the eye with glaucoma is rapidly decreasing.
Inborn glaucoma is caused by defect in the structure of ocular drainage system. In this case newborn children have high intraocular pressure, in some cases there might be extension of the eyeball. Sometimes disease can be detected in child or juvenile age.
Secondary glaucoma appears as a consequence of other ocular diseases (inflammatory, vascular, dystrophic, traumas, or lens pathologies) Reason for higher intraocular pressure in case of secondary glaucoma usually lies in disturbance of intraocular fluid drainage.
Glaucoma with a normal (low) intraocular pressure вconsequently arises from blood circulation disorder in the eye. In case of this type of glaucoma vision loss, narrowing of the vision field, optic nerve atrophy happen on the background of normal intraocular pressure.
As a rule, glaucoma appears on both eyes, but not simultaneously: on the second eye glaucoma might develop in a few months or years.
Diagnostics of glaucoma
In Fyodorov’s Clinic diagnostics of glaucoma is done with the help of precise equipment and consists of the following main examinations:
- Visual acuity examination;
- Visual field examination (perimetry);
- Intraocular pressure examination (tonometry);
- Hydrodynamics of the eye examination (tonography);
- Examination of the optic nerve during examination of the back part of the eyeball (ophthalmoscopy).
Results of the examinations mentioned above will help the doctor to recommend the scheme of treatment that You need. Doctor might suggest additional examinations if necessary.
Sometimes intraocular pressure is high while there are no other symptoms of glaucoma. This happens because of different endocrine disorders and requires an overall examination of the patient.
People, who have diabetes, high blood-pressure or atherosclerosis more often suffer from glaucoma. That’s why they should regularly visit not only therapeutist and endocrinologist, but also ophthalmologist not less than twice a year.
Glaucoma treatment
Individual and overall approach for choosing the scheme of glaucoma treatment offered in Fyodorov’s Clinic, helps thousands of people to keep their eyesight.
Therapeutic treatment
Usually medicines are prescribed in the beginning of the treatment course. It can be special eye drops to lower the intraocular pressure or pills to improve alimentation of the optic nerve.
If medicines prove to be inefficient, laser or surgical treatment is prescribed. In Fyodorov’s Clinic in Krasnodar both ways of treatment are done at high level using highly effective equipment.
Laser treatment
Laser beam penetrates the eye, affects the drainage system and improves flow-out of the intraocular fluid stabilizing the intraocular pressure.
Laser treatment is painless, takes not much time and is done on an outpatient basis. It allows to avoid surgical interference on the eyeball.
Laser treatment is efficient at early stages of glaucoma and in case of glaucoma attacks.
In other cases surgical treatment efficiently helps to the patients.
Surgical treatment
There is a way to keep eyesight of the patient suffering glaucoma by creating a new drainage channel. This operation should be performed at early stages.
Svyatoslav Fyodorov developed a new operation for treatment of glaucoma, so called "non-penetrating deep sclerectomy". It can be used for any type of open-angle glaucoma. Advantage of such an operation is that it can be performed without dissection of the eyeball. Fyodorov’s version of sclerectomy cuts down the risk of having infection or complications.
Operation is performed under local anesthesia with assistance of anesthetists, who would help you to get ready for operation, and relax. Highly experienced surgeons in S.N. Fyodorov’s Clinic perform the operation in operating room equipped with the latest microscopes, high quality and precise microsurgical instruments. Average duration of such operation is 20 minutes.
Depending on recommendations, other types of antiglaucoma operations developed in our Clinic are performed as well.
Complex treatment
Quite often patients with glaucoma also have a diagnosis of cataract (haziness of the lens). In this case it is possible to make 2 operations at once: non-penetrating deep sclerectomy and a lens change. Complex treatment considerably improves patient’s eyesight, takes less time and lowers operational injuries to their minimum.
