الجلوكوما .. كتاب في سبيل موسوعة علمية .. الدكتور أحمد ذكي

Glaucoma

It used to lead its companion to blindness, and then the kindness of God came, according to scholars.

Glaucoma, in short, is an eye disease that, if not treated early, can lead to blindness.
It led to blindness until a treatment was discovered, provided that the treatment did not come too late.

The cause of the disease is pressure that occurs in the fluid of the eye, resulting in damage to the visual organs, especially the fibers of the optic nerve.

The word is a Greek word that includes the meaning of greenery.
The reason for this is that when patients in the past became blind, their irises would appear green.

- Eye ;

In order to understand how this disease occurs, we must remember the eye, its structure, and what is happening in it.

The eye is roughly the shape of a ball, so that its body is called the eyeball, and this ball has two parts or two large cupboards, and it is filled with a transparent, gelatinous substance that was called in the past the term vitreous moisture. According to the ancients, water is moisture. Then there is a small cupboard in front of the spring, containing water, salt, and other things. It is called water humidity, which is more like water.

It is noted that it separates the two cabinets, the back and the front
The lens of the eye and the links that connect to the ciliary muscle (on both sides). This muscle controls the curvature of the lens, which is required by the distance or proximity of the visible object, so that its image appears clearly on the retina located at the back of the eye, or at its bottom, as they say.

What we are interested in talking about at this time is the closet, as there is the front lens of the eye. Look at it starting at the back and its connections to the ciliary muscle, or ciliary body, followed by the iris, which is what gives the eye its black, hazel, or blue color.

In the iris is the opening known as the pupil, through which the rays of the visible object enter. Then comes the cornea, which is a transparent membrane more curved than the rest of the eyeball.

This front closet has two gaps: a gap between the lens, the iris, and the ciliary body (which includes the ciliary muscle), and a gap between the lens and the iris from behind, and the cornea from the front. The two gaps are filled with water moisture.

- Glaucoma;

This front cabinet, with its two gaps, is the target of all this talk about the eye, from which we arrive at the description of the disease, glaucoma. The disease is a defect that basically begins in this closet and its watery humidity.

Water moisture is water that contains salt and other things that raise its pressure above the pressure of blood (blood plasma) in the body, and it is transparent water.

The ciliary body is what supplies this reservoir with its water moisture.

In order for water moisture to remain at a known pressure (1), it must have a drain. This moisture comes out of a channel known as the Shlemm Canal.

The eye remains healthy as long as its inside and outside are equal
Of which .
But it happens that things happen in the eye that hinder the exit of excess moisture, such as when Schlemm's canal becomes clogged. So the eye is dysfunctional as an instrument of sight. It was made to work under this amount of pressure, and when it increases, the cornea is affected (it actually works like a lens that refracts the rays and helps the lens of the eye to focus any powder images of objects on the retina. The lens is also affected, as it is then unable to form as it should for every situation, and the ciliary muscle malfunctions, so it does not It is able to form the lens, and the optic nerve itself is damaged.
This is glaucoma.

- Acute and chronic glaucoma;

Glaucoma may strike the person suddenly. And injury
It usually comes at night. It appears as severe pain that affects one eye, and the pain may not be in the eye, but in the head, shooting through it like an arrow from side to side. The patient may think that the pain is coming from the nose or from the tooth. The pain may be so severe that the patient vomits and appears as if he is suffering from biliary colic.

Sight soon decreases, and the ball of the eye appears rigid upon palpation, the eye becomes red, the cornea becomes cloudy, and the pupil of the eye becomes dilated.

Glaucoma may sneak up on the patient, accompanied by a little pain, such that the patient, and even the doctor, ignores it and does not pay attention to it until it has passed a long, annoying stage.

The person may suffer from pain that comes and then goes away, and he does not wake up from it.

(1) The pressure in liquids is the osmotic pressure that forces the movement of water in solutions. For example, if we put water containing salt in a porous container and put this container in clear water, the water will move and enter where the water and salt are, as if the salt is pressing on its water to make way for new water to enter it so that the pressures are equalized.)

It often happened that the patient, before the disease had matured, complained of poor eyesight, and changed his glasses, then changed them after a short period, then again for a short time before he became aware of the disease.

The patient may complain of confusion in what he sees, and may see circles
Colored around a white flame or white light source.

All of this can be confirmed by the ophthalmologist by detecting an increase in eye pressure and loss of the central part of the field of vision, as well as by looking at the optic nerve at the bottom of the eye, as it has retracted backwards to the point that it makes something resembling a click.

- Glaucoma treatment;

There was no treatment for it before 1857, that is, about a century ago
Of time.
It ended in blindness.
And this year came Von Graafe
By treating him. It is creating an incision in the front cupboard, where the watery moisture is, from which the fluid comes out, due to which the pressure increases, and thus the pressure drops to what it was while the eye was healthy.

The incision he made was at the junction between the cornea and the iris, and because of it, he cut out a small part of the iris.

The newer surgery is similar to the surgery invented by Art Graff, except that what is cut from it is not the iris, but rather the hard layer that covers the outside of the eyeball, of which the cornea is an extension.

- Treatment with medication;

When the progress of the disease is very slow, and until the eye is prepared for surgery, or when surgery is not possible, the disease can be controlled and limited so that it does not increase, by dripping drops into the eye every day, morning and evening, of a solution of the drug Esertine, at a concentration of one percent.

It is preferable to have both eyes in diameter, as most likely the other eye is affected due to the anxiety that the patient has experienced due to this eye disease. Anxiety is often the catalyst for illness the first time.

There is no harm in treatment with drops if the patient continues with it for months or years. It adjusts the pressure of fluid in the eye whenever it falls into it.