If you've actually been diagnosed with glaucoma--a condition that can lead to blindness--count yourself lucky: you can take action. With today's treatments, you need never miss a sunset, the smile on a child's face or even your favourite TV show.
There is no need for anyone with glaucoma to lose their vision. The therapies available today are safe and very effective. However, because they control only the progress of the disease, they can't reverse damage that's already been done. Obivously, the sooner you can seen an eye doctor (opthalmologist), the better. Treatment will include regular eye examinations--perhaps as often as once every three months--along with medications and, if necessary, surgery.
Treatment Options
Try vitamin E. Although there is no evidence to show that it works directly on glaucoma, this nutrient is often recommended by doctors for its ability to clean up the destructive oxygen molecules known as free radicals, which roam through your circultory system. Vitamin E may also help improve your visual field. The standard dosage, in capsule form, is 400 IU a day.
Sit still and relax. Meditation, biofeedback and other approaches to relaxation seem to have some therapecuitc effects on glaucoma, although no-one knows why.
Keep your head up. Anything that requires you to be in a head-down position, such as bending over to tie your shoes or practising certain yoga poses like head or shoulder stands, may increase your IOP. Try to keep your forehead from dropping lower than your chin for any extended length of time.
What is happening
Having glaucoma means that the fibres of your optic nerve are beginning to die off, most likely due to excessive fluid pressure inside your eye. This problem, called intraocular pressure (IOP), is caused by a watery fluid (aqueous humour), which normally fills your eyeball and produces IOP in the same way that air from a pump creates pressure in a tyre. To keep the pressure at a safe level, some fluid constantly drains out through a sievelike network of connective tissues called the trabecular meshwork (see illustration) or through an alternate drainage system called the uveosclearl pathway. It then empties into a drainge channel, located where the iris and the cornea meet; this area of the eye is known as the drainage angle.
When anything prevents the acqueous fluid from draining, pressure increases in your eye and eventually kill nerve cells. If the condition isn't treated with medication or surgery, your peripheral vision--your ability to see objects a the very edge of your visual field--will begin to disappear. As even more cells die, your central vision will go as well. The final result: total, irreverisble blindness.
LIKELY FIRST STEPS
Typcially, open-angle glaucoma, which is the most common form, occurs when the trabecular meshwork in your eye becomes partially blocked. The clear fluid known as aqueous humour (which normally drains from the eye into the blood stream at the same rate that it's produced) slowly builds up. This puts pressure on the optic nerve, causing the gradual loss of vision that, if left untreated, can result in blindness.
In Australia and New Zealand, the common type of glaucoma is open-angle glaucoma, which occurs when the trabecular meshwork becomes partially blocked for reasons that are unknown (see illustration). Although the drainage angle remains open, the aqueous humour drains out too slowly, leading to fluid backup and a gradual but persistent elevation in pressure. You can have this condition for years before it becomes noticeable.
A far rarer variation is closed-angle glaucoma (see on shortly). It causes intense pain and other symptoms, and can happen suddenly. It's a medical emergency, and you need to get immediate treatment.
Exactly which biological mechanism actually triggers glaucoma remains a mystery, but there are a few suspects. One is a natural body process called apoptosis, during which cells actually commit suicide. This may contribute to the pressure in open-angle glaucoma by reducing the number and activity of the cells in the eye's drainage channel. Another possibility is low blood pressure or other circulatory problems, which reduce blood flow to the optic nerve.
Having glaucoma means that the fibres of your optic nerve are beginning to die off, most likely due to excessive fluid pressure inside your eye. This problem, called intraocular pressure (IOP), is caused by a watery fluid (aqueous humour), which normally fills your eyeball and produces IOP in the same way that air from a pump creates pressure in a tyre. To keep the pressure at a safe level, some fluid constantly drains out through a sievelike network of connective tissues called the trabecular meshwork (see illustration) or through an alternate drainage system called the uveosclearl pathway. It then empties into a drainge channel, located where the iris and the cornea meet; this area of the eye is known as the drainage angle.
When anything prevents the acqueous fluid from draining, pressure increases in your eye and eventually kill nerve cells. If the condition isn't treated with medication or surgery, your peripheral vision--your ability to see objects a the very edge of your visual field--will begin to disappear. As even more cells die, your central vision will go as well. The final result: total, irreverisble blindness.
LIKELY FIRST STEPS
- Specialised tests to determine the level of pressure in your eyes and indicate how far the disease has progressed.
- Eyedrop medications to bring pressure inside your eyes under control.
- Surgery only if medications don't work or cause problematic side effects.
Typcially, open-angle glaucoma, which is the most common form, occurs when the trabecular meshwork in your eye becomes partially blocked. The clear fluid known as aqueous humour (which normally drains from the eye into the blood stream at the same rate that it's produced) slowly builds up. This puts pressure on the optic nerve, causing the gradual loss of vision that, if left untreated, can result in blindness.
In Australia and New Zealand, the common type of glaucoma is open-angle glaucoma, which occurs when the trabecular meshwork becomes partially blocked for reasons that are unknown (see illustration). Although the drainage angle remains open, the aqueous humour drains out too slowly, leading to fluid backup and a gradual but persistent elevation in pressure. You can have this condition for years before it becomes noticeable.
A far rarer variation is closed-angle glaucoma (see on shortly). It causes intense pain and other symptoms, and can happen suddenly. It's a medical emergency, and you need to get immediate treatment.
Exactly which biological mechanism actually triggers glaucoma remains a mystery, but there are a few suspects. One is a natural body process called apoptosis, during which cells actually commit suicide. This may contribute to the pressure in open-angle glaucoma by reducing the number and activity of the cells in the eye's drainage channel. Another possibility is low blood pressure or other circulatory problems, which reduce blood flow to the optic nerve.
QUESTIONS TO ASK
Will treatment keep my vision form getting worse?
How do I know if my medications are working?
Do you think I'm a candidate for surgery?
Will the dosage of the beta-blockers I take for high blood pressure have to be adjusted if I use beta-blocker eyedrops?
Are there any other drugs I'm taking that could be aggravating my condition?
Will treatment keep my vision form getting worse?
How do I know if my medications are working?
Do you think I'm a candidate for surgery?
Will the dosage of the beta-blockers I take for high blood pressure have to be adjusted if I use beta-blocker eyedrops?
Are there any other drugs I'm taking that could be aggravating my condition?
Treatments
There is no need for anyone with glaucoma to lose their vision. The therapies available today are safe and very effective. However, because they control only the progress of the disease, they can't reverse damage that's already been done. Obivously, the sooner you can seen an eye doctor (opthalmologist), the better. Treatment will include regular eye examinations--perhaps as often as once every three months--along with medications and, if necessary, surgery.
Treatment Options
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Miotics Old-line treatment to increase fluid outflow.
------------------------------------------------------------------------------------------------------------------------------------------
Beta-blockers Usually the first choice for reducing IOP.
-------------------------------------------------------------------------------------------------------------------------------------------
Carbonic anhydrase inhibitors Reduce fluid in eye; topical or oral.
-------------------------------------------------------------------------------------------------------------------------------------------
Alpha-2 adrenergic agonists Brimoindine may replace some beta-blockers.
--------------------------------------------------------------------------------------------------------------------------------------------
Prostaglandin agonsits Increase fluid outflow and blood flow to eye.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Laser trabeculoplasty Very effective but eyedrops still needed.
---------------------------------------------------------------------------------------------------------------------------------------------
Trabeculectomy Usually done if drops and laser have failed to control eye pressure. Creates
a new channel to allow the fluid in the eye to drain.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Aerobic exercise May lower IOP by up to 20%.
----------------------------------------------------------------------------------------------------------------------------------------------
Care with liquids Not too much coffee; regulate fluid intake.
TAKING CONTROL
------------------------------------------------------------------------------------------------------------------------------------------
Miotics Old-line treatment to increase fluid outflow.
------------------------------------------------------------------------------------------------------------------------------------------
Beta-blockers Usually the first choice for reducing IOP.
-------------------------------------------------------------------------------------------------------------------------------------------
Carbonic anhydrase inhibitors Reduce fluid in eye; topical or oral.
-------------------------------------------------------------------------------------------------------------------------------------------
Alpha-2 adrenergic agonists Brimoindine may replace some beta-blockers.
--------------------------------------------------------------------------------------------------------------------------------------------
Prostaglandin agonsits Increase fluid outflow and blood flow to eye.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Laser trabeculoplasty Very effective but eyedrops still needed.
---------------------------------------------------------------------------------------------------------------------------------------------
Trabeculectomy Usually done if drops and laser have failed to control eye pressure. Creates
a new channel to allow the fluid in the eye to drain.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Aerobic exercise May lower IOP by up to 20%.
----------------------------------------------------------------------------------------------------------------------------------------------
Care with liquids Not too much coffee; regulate fluid intake.
TAKING CONTROL
Try vitamin E. Although there is no evidence to show that it works directly on glaucoma, this nutrient is often recommended by doctors for its ability to clean up the destructive oxygen molecules known as free radicals, which roam through your circultory system. Vitamin E may also help improve your visual field. The standard dosage, in capsule form, is 400 IU a day.
Sit still and relax. Meditation, biofeedback and other approaches to relaxation seem to have some therapecuitc effects on glaucoma, although no-one knows why.
Keep your head up. Anything that requires you to be in a head-down position, such as bending over to tie your shoes or practising certain yoga poses like head or shoulder stands, may increase your IOP. Try to keep your forehead from dropping lower than your chin for any extended length of time.
No comments:
Post a Comment