With various online stores, it is now possible to order glasses according to certain specifications and wishes. However, not every visual impairment or visual disorder indicates the need for glasses. Several causes can underlie the condition. One cause, which has become increasingly common in younger people in recent years, is glaucoma. This article deals with a special form of the disease, narrow-angle glaucoma. What does it mean? How is it treated? How can the disease be prevented? This and much more is explained below.
What is narrow-angle glaucoma?
Infographic on the anatomy and structure of the eye in glaucoma. Click image to enlarge. Glaucoma, colloquially known as glaucoma, is manifested by the optic nerve being damaged by various causes. This leads to a loss of the visual field. Furthermore, the intraocular pressure is enormously increased. Different forms of glaucoma are distinguished, such as open-angle glaucoma, normal-pressure glaucoma, secondary glaucoma or narrow-angle glaucoma, which is the subject of this article. Narrow angle glaucoma is characterized by a narrowing of the chamber angle, which increases the resistance of the outflowing eye fluid. Since the iris is curved more than normal in this disease, it also obstructs the outflow. Especially in the dark, the chamber angle is narrowed 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 physician.
Causes
There is no specific cause that leads to glaucoma. However, it can be basically stated that increased intraocular pressure is related to it. Furthermore, the optic nerve is not supplied with sufficient blood. This undersupply can also make it more likely to develop glaucoma. Our eyes need aqueous humor to perform all functions for normal vision. This aqueous humor is produced but cannot drain normally in narrow-angle glaucoma. Therefore, a pressure is created which constantly affects the optic nerve. This pressure constricts the nerve, which ultimately leads to impaired vision. Other causes that promote the disease are nearsightedness or farsightedness, low blood pressure, metabolic diseases, advanced age, a thin cornea or hereditary factors.
Symptoms, complaints and signs
As mentioned earlier, sometimes intraocular pressure can increase to a critical level only at night, which is why the condition may go undetected by ophthalmologists. Therefore, no symptoms are noticeable. When complaints, such as visual disturbances or failures in normal vision are observed, a disease is usually advanced. A complete regeneration is now no longer possible, because the optic nerve is already damaged. Nevertheless, an ophthalmologist should definitely be consulted in order to curb the progression of glaucoma. Without this procedure, the sufferer will go blind. In an acute attack, severe pain suddenly occurs in one eye and the corresponding side of the head in conjunction with nausea and vomiting. This is an angle block. The aqueous humor in the eye can now no longer drain. Intraocular pressure values of up to 70 mmHg can occur. Therefore, fast action must be taken 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 “constantly foggy vision” or blurred vision. Even in babies, congenital glaucoma can lead to damage and even complete blindness. Therefore, newborns of already ill glaucoma patients should be examined immediately in order to exclude damage or to be able to treat it immediately. If an adult is diagnosed with congenital glaucoma, this is often manifested by a cloudy cornea, increased sensitivity to light or constantly watery eyes. Surgery is the only option for improvement.
Complications
Due to the often late detection of the disease, it can progress if left untreated. Thus, incurable damage to the optic nerve may have already developed. If the disease is already far advanced, surgery may be necessary to preserve eyesight. In this case, an artificially created drainage channel must be created in the eye.In connection with surgery, complications can occur at any time, such as infections, bleeding, wound healing disorders, problems with anesthesia, etc. In the special case of eye surgery, bleeding or painful inflammation can occur in the eye, resulting in irritated and swollen eyes. The laser method is also used to treat glaucoma. However, this is not a permanent solution. Since this treatment must be performed repeatedly, scarring and inflammation can develop. If the disease is detected in a non-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 purpose. These drugs effectively lower the internal pressure in the eye. Complications in the field of this treatment method are not known except for slightly burning eyes when the drops are applied. Mild allergic reactions to ingredients or preservatives have been reported sporadically.
When should you see a doctor?
Anyone suffering from declining vision should definitely see an ophthalmologist. However, this is not only recommended for people of older age. If a change in vision continues to be felt, such as blurred vision, “bent” edges, holes or black spots in the image, or constant flashes, a specialist should be consulted immediately. If medical treatment is not sought, this condition will lead to blindness. Another sign of narrow-angle glaucoma is constant headaches or painful eyes. If these pains persist for several days, a visit to the doctor should also be planned. If nausea and vomiting also occur and the eyes are red, these are also signs of the disease. If there is already a family history of the condition, other family members should have regular eye pressure screenings. Likewise, every person over the age of 40 should have an ophthalmological check-up, as the risk of disease increases with age. Even small changes can be noticed that would go unnoticed in normal everyday life.
Diagnosis
In the rarest cases, narrow-angle glaucoma itself is detected because of pain or the like. The condition is noticed by a thorough optometrist or ophthalmologist. These have equipment for measuring intraocular pressure. If a high intraocular pressure is measured, it is already a sign of glaucoma. An intraocular pressure from 21 mmHg is considered critical and leads to further examinations. Therefore, the ophthalmologist will examine the visual field to detect further limitations. Furthermore, the fundus of the eye is examined with an ophthalmoscope. An enlarged cavity (cup) will be seen where the optic nerve exits. Depending on how deep and how extensive this excavation already 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 purpose. Corneal pachymetry is used to determine the thickness of the cornea. OCT (Optical Coherence Tomography) or GDx (Laser Polarimetry) can be used to determine the thickness of the nerve fibers in the immediate vicinity of the optic nerve. The use of these procedures will provide information as to whether or not actual glaucoma disease is present. Anyone who is sent by an ophthalmologist for such an examination on suspicion of an existing disease for the purpose of making a definite diagnosis does not have to reimburse any costs. Otherwise, these examinations are usually not included in the benefits provided by the health insurer.
Treatment and therapy
If glaucoma is recognized as such, treatment should be given immediately. If the disease is in an early stage, massive surgery will not be necessary. Treatment with eye drops will be given initially. Drops with active substances of prostaglandins, cholinergics or beta-blockers are used. Drugs of this type are intended to lower the internal pressure in the eye, facilitate aqueous humor outflow, and increase ciliary body transparency. A combination of different agents is also possible. If glaucoma is not stopped or even worsens, laser therapy may be necessary as a surgical intervention. In most cases, however, simply dripping several times a day is sufficient at the beginning.If surgery is unavoidable, the passage of aqueous humor in narrow-angle glaucoma is often optimized by laser. This improves the flow of aqueous humor between the chambers of the eye. In other treatments, the ciliary body is sclerosed or argon laser trabeculoplasty is used, which also improves the flow of aqueous humor. Iridectomy is another option for preserving and improving vision. A minor procedure is performed on the conjunctiva, sclera and ciliary body via laser. To reduce intraocular pressure, cataract surgery is also used, in which the iris is treated.
Outlook and prognosis
If the diagnosis “narrow-angle glaucoma” is present, this may well be a shock at first. However, there are good prospects for a life without restrictions. It is true that this disease cannot be cured. Nevertheless, immediate ophthalmological treatment can determine exactly which stage of the disease the patient is in. If appropriate treatment is then started, the glaucoma can be stopped. The 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 immediate medical treatment is not given in this case either, the patient will lose his or her sight in this eye.
Prevention
In this field, there is no direct possibility of prophylaxis. It is important that everyone sharpens his perception and reacts immediately to changes in vision. Here, “early detection preserves eyesight” applies! Those who suffer from diabetes or circulatory disorders should make regular ophthalmologist appointments. In this way, the intraocular pressure as well as the general condition of the eyes can be constantly monitored. Likewise, people who already have known glaucoma diseases in their relatives should regularly visit the specialist.
Follow-up care
Narrow-angle glaucoma should always be treated by a physician first. In this context, the options for follow-up care are severely limited in most cases, so that the affected person is primarily dependent on the removal of the disease to prevent further complications and discomfort. The earlier the disease is detected, the better the further course of this disease usually is. 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, but the patient should pay attention to the correct dosage. Furthermore, surgical interventions are often necessary to permanently alleviate the symptoms. After such an operation, the patient should in any case rest and take care of the whole body, especially the eyes. Regular examinations are also very useful after a successful operation. In most cases, the life expectancy of the affected person is not reduced by this disease.
What you can do yourself
It is not possible to treat this disease independently. Therefore, every patient should regularly perceive all suggested examinations. In this way, progression of the disease can be detected immediately. In whom narrow-angle glaucoma was diagnosed early, it is essential to use the prescribed eye drops regularly and at the exact time interval. In addition, every affected person 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 unnecessarily poison the organism. Instead, cleansing and purifying foods should be consumed. These include fruits, vegetables and sprouts. Therapeutic fasting also brings relief to some patients. Furthermore, attempts should be made to reduce stressful situations to a minimum. In addition, attention must be paid to eye strain and – if possible – it must be reduced. Targeted eye training can be carried out. This provides relief and improves the mental state of the affected person. Here is an exercise: the arm is stretched out with the thumb pointing upwards, while the arm is moved in different directions, the thumb is observed, but the head is not turned. As a person affected, everyone can thus do various things to be able to lead a full and fulfilling life despite the disease!
