Glocom glaucoma :How to diagnose and treat?

Glocom glaucoma is a common disease that is one of the main causes of permanent blindness in the world as well as in Vietnam, which has a great impact on public health.

Glocom glaucoma is a term used to address a group of pathology of the optic nerve head, chronically progressive, characterized by market damage, concave optic discs, and associated with high glaucoma.

Glocom has many classifications, currently in Vietnam often classified into:

Original glocom (the most interested), including:

• Glocom corner of the original closure (commonly encountered in Vietnam).
• Glocom primitive open angle.

Glocom minor: appears after disorders in the eyes and the whole body, such as traumatic glocom, due to uveitis, due to the pathology of the glassy body,…

Glocom is dangerous in that if it is not detected and treated in a timely manner, no treatment or surgical intervention will recover the damage it has caused.

For each disease, the patient will have different symptoms:

Glocom angle closes the typical level: symptoms appear suddenly, intensely:

• Eyes sore suddenly, intensely, pain spreads to the top of the head.
• The eyeball is as tight as a marble.
• Red eyes, masonry eyelids, tearing, fear of light.
• The patient's vision decreases rapidly even completely, seeing blurred like through the mist, looking at glowing objects that see red-green circles.
• Possible signs of body pain: abdominal pain, vomiting, nausea, diarrhea, sweating…. make the patient mistakenly think of it as a fever, subjective self-treatment, when coming to the hospital, he is completely blind.

Semi-severeangle glocom : Symptoms are the same as angular glocom closes the attack, but less intensely, occasionally appearing eye aches, transient headaches accompanied by blurred vision, through the return of vision to normal, but the frequency, the degree of attacks gradually increases, at the same time vision is decreasing.

Chronic closure angle glocom:Very rare, often asymptoatic, the majority of patients who visit vision examination have severely reduced or completely lost.

Open-angle glocom: The disease silently progresses chronically, in turn through each stage, the patient does not notice a decrease in vision, so often visits at a late stage when the disease is already severe. Most patients do not have eye aches or headaches, some have severe sensations, transient eye tension, blurred vision like through the mist, seeing glowing objects with red-green circles, manifestations appearing in short bouts and then running out on their own, causing the patient to subjectively not go to the doctor.

The doctor will base on the clinical symptoms of the patient, and proceed to:

• Assess the patient's vision.
• Look at the pre-room angle, estimate the depth of the pre-room angle using The Henrick Test.
• Measure the glaucoma.
• Market measurement.
• Endoscopy of the bottom of the eye or a semi-rear OCT scan (visual hemp ctectar, evaluation of the retinal nerve fiber layer).

Glocom treatment must accurately identify the body of the disease, because the treatment methods of each body of the disease are different.

Glocom angle closure emergency is an ophthalmal emergency, the treatment must be carried out urgently, actively to lower the glaucoma, relieve pain and sedative for patients:

• In the eyes: Pilocarpin test 1% – 2% every 1 hour, maintained until the glaucoma is lowered, check 3-4 times / day.
• Acetazolamid 0.25 g, taken 2-4 24h.
• If the patient vomits a lot, intravenous diamox 500 mg x 1 ampl tube.

The above drugs must be prescribed by a doctor and closely monitor the patient's use of the drug.

Medical treatment only solves the ophthalmthalmic condition in order to preserve the patient's vision. With closed angle glocom often requires surgical treatment. The selected method of surgery must be appropriate to the degree and stage of the disease.

Currently there are 3 glocom surgical methods that are commonly used. Each method has certain pros and cons, the patient will be examined, consulted and specified by the doctor.

• Glocom surgery by corneal raft cuttingmethod : This is a method that is born very early, the doctor will proceed to remove part of the cornea raft and iris to create an escape route for the hydrolylly, stabilizing the pressure in the eyes.
• Glocom surgery by the method of transplantation of the drainage tube:Use a tube about 1.3 cm in length from silicone material as a transplanted drain pipe into the patient's eyes. This method has some limitations, such as after surgery the patient is quite uncomfortable due to eye bandages, and the monitoring time takes several weeks.
• Laser glocom surgery: This is a cutlery-free method, the doctor uses a laser beam to shine into the cornea raft area – the drainage area, creating about 100 small holes to drain the hydrolypea of the eye. The whole process is very fast (it only takes 15-20 minutes), brings high efficiency, few complications. Laser glocom surgery is a major step forward in modern medicine, which is being applied very popularly. After laser glocom surgery, in the next 2-5 years the patient should be monitored, in case of recurrence of the disease.

Open-angle glocom requires treatment with the aim of lowering the glaucoma below the level that damages the neurological vision and visual function. Treatments must be the safest, least affecting the patient's life. Top-based drugs for the treatment of open-angle glocom are quite a lot, such as: beta-adrenergic group, adrenergic strengthening group, cholinergic strength group, prostaglandin group.

The doctor will prescribe the appropriate medication, however the patient must strictly follow the course of treatment throughout life under the doctor's periodical monitoring. If medical treatment does not bring results, the patient will need surgical methods.

The purpose of glocom treatment is to prevent the disease from continuing to progress causing damage to the visual nerve. Patients after surgery should go for an eye exam, monitor the glaucoma every 3 months in the first year, then periodically every 6-12 months.

For patients treated with open-angle glocom with eye examination drugs, glaucoma should be examined every 2 months, market examination and bottom examination every 3-6 months. Follow-up treatment is an important factor that greatly influences the final result.

In many cases, glocom has been detected and treated, but patients think that it is completely cured so they do not go to the doctor, follow up, as a result, the disease continues to smolder, leading to complete loss of vision. Therefore, patients need to follow follow up periodically from the time of detecting the disease, persistent lifelong treatment to control the course of the disease, preserve their vision.

Glaucoma blindness can be prevented by early detection, appropriate treatment, and regular monitoring. The Glaucoma package at Share99 Times City International Health Hub will perform comprehensive examinations and prescribe surgery (if any) to customers with symptoms of Glaucoma.

Customers can go directly to Share99 Times City for a visit or contact hotline 0243 9743 556 for assistance.