Ophthalmic hypertension. Ophthalmic hypertension - causes and treatment

Hypertension - insidious disease, people do not always feel its manifestations immediately. The body gets used to high blood pressure and a person can feel normal even at values \u200b\u200bof 180-200. In this case, hypertension does not noticeably affect the heart vascular system, heart, kidneys and fundus.

The effect of hypertension on vision can be guessed by several signs. If visual acuity suddenly deteriorates, fog or a veil appears in front of the eyes, an unclear image, flickering flies are most likely indicators high pressure... More detailed eye changes can be seen only when examining the fundus.

High arterial pressure disrupts normal blood flow and leads to pathological processes inside the eye. With pressure surges, miniature arteries located on the retina of the eye thicken, swell, the gap between them narrows. Enlarged arteries make it difficult for blood to drain. As a result high blood pressure the walls of the arteries can be damaged, causing hemorrhage into the tissue of the eye. With a prolonged course of the disease, edema may form optic nerve... This will result in partial or complete loss of vision.

REFERENCE! Hypertension and hypertension are different concepts. Hypertension is a chronic disease in which blood pressure is constantly high. Hypertension - periodic pressure surges.

What eye diseases can cause hypertension?

Prolonged high blood pressure can cause irreversible or reversible changes in the vessels and tissues of the eye, which will lead to a number of diseases.

• retinal disinsertion;
• vascular thrombosis;
• hemorrhage;
• glaucoma;
• hypertension of the eyes;
• angiopathy;

At the heart of all eye diseases provoked by high blood pressure is damage to the blood vessels of the eye.

Retinal disinsertion

A serious illness caused by the ingress of intraocular fluid between the layers of the retina. Which leads to the death of the layer and subsequently to blindness. The first symptoms of detachment are the appearance of flies and blackheads in front of the eyes, flashes of light, and curved lines. When the form is running, a black veil covers part of the view.

Retinal detachment can only be treated surgically... The disease requires emergency treatment. Early diagnosis prevents the inevitable loss of vision.

Retinal vascular thrombosis

Due to stagnation of blood, vascular permeability increases, which leads to hemorrhages and retinal edema. It is expressed by a sharp decrease in vision, the appearance of blind spots.

In most cases, the disease is cured within a few months with the help drug treatment... Patients are recommended injections of preparations that dissolve blood clots, drops that reduce intraocular pressure and improve blood supply, injections to relieve edema.

In severe advanced cases, problem vessels are coagulated with a laser.

Retinal hemorrhage

Arterial hypertension causes rupture blood vessels, as a result of which part of the blood enters the retina of the eye and blocks the conduction of visual impulses. Lack of clarity of vision, duality or blurring of objects are symptoms of hemorrhage. With a large area of \u200b\u200bdamage, vision may disappear.

For treatment of mild form, it is enough to rest the eyes for a period of 2-3 weeks. However, you can take vaso-strengthening drugs.

In more complex cases, surgery is performed to remove part of the affected areas.

Glaucoma

Due to impaired circulation of fluid, ocular pressure rises, which leads to atrophy of the optic nerve. An irreversible disease, without timely treatment, leads to complete blindness. It manifests itself in sharp pains, deterioration of vision, a light spot appears, the field of vision gradually narrows.

At the initial stages, drug treatment. Aimed at reducing pressure. Glaucoma cannot be cured; you can only slow down its development at a certain stage. Over time, the need arises surgical intervention.

Ocular hypertension

A milder form of glaucoma. Without timely diagnosis and treatment, it can lead to the development of glaucoma. It proceeds without noticeable symptoms, but is easily diagnosed by an ophthalmologist.

With hypertension, the eyes are treated directly with the disease that provoked the pathology.

Angiopathy

It causes disturbances in micro blood circulation and, as a result, a violation of the blood supply to the optic nerve. It proceeds without symptoms. The main indicator for the examination of an ophthalmologist is a long course of hypertension.

Concept "Ocular hypertension" most often refers to any situation in which pressure inside the eye, i.e. , it turns out. Eye pressure is measured in millimeters of mercury (mmHg). the pressure is from 10 to 21 mm Hg. Art. Ocular hypertension occurs when the eye pressure is above 21 mm Hg. Art.

• Intraocular pressure is more than 21 mm Hg. Art. measured with a tonometer in two or more visits to the doctor;
• The optic nerve is normal;
• The absence of signs of glaucoma is detected with a practical vision test that evaluates peripheral (or lateral) vision.

To establish others possible reasons high eye pressure, an ophthalmologist (a doctor who specializes in the treatment of eye diseases) determines whether the system for removing fluids or other secretions is closed. For this, a method called gonioscopy is used. Gonioscopy involves the use of special contact lenses to check how open, closed or narrowed the excretory canals of the eyes.

No signs of any eye disease. Some of these diseases can increase intraocular pressure.

Ocular hypertension should not be considered as a separate disease. This term applies to initial stage glaucoma. A person with ocular hypertension may be suspected of having glaucoma. A vision test can reveal an affected optic nerve.

As previously mentioned, increased intraocular pressure may have other causes. However, within this article, ocular hypertension refers primarily to increased intraocular pressure without loss of vision or any damage to the optic nerve. Glaucoma occurs with high intraocular pressure, damage to the optic nerve, and loss of vision.

Studies using existing tests show that 3-6 million people, including 4-10% of the population over 40, have an intraocular pressure of 21 mm Hg. Art. or higher with no signs of glaucomatous damage. Research conducted over the past 20 years helps determine characteristics people with ocular hypertension.

Recent data from the Research on Ocular Hypertension showed that people with ocular hypertension have an average 10 percent risk of developing glaucoma over five years. The risk can be reduced by up to 5% if eye pressure is lowered with medication or laser surgery. However, the risk can be reduced to less than 1% per year due to significantly improved methods for detecting glaucomatous damage. These methods may allow treatment to be started before blindness occurs. Future research will help further determine the risk of developing glaucoma.

Patients with thin corneas may be at risk of developing glaucoma, so the ophthalmologist may use a special device called a pachymeter to measure the thickness of the cornea.

The likelihood of ocular hypertension is 10-15 times higher than that of primary open-angle glaucoma, its common form. This means that out of 100 people over 40, about ten of them will have blood pressure above 21 mm Hg. Art., but only one will have glaucoma.

Over a 5-year period, several studies have shown that the incidence of glaucoma in people with ocular hypertension is approximately 2.6-3% for an intraocular pressure of 21 to 25 mmHg. Art., 12-26% for a pressure of 26 to 30 mm Hg. Art., and approximately 42% for pressures above 30 mm Hg. Art.

In about 3% of people with ocular hypertension, retinal veins can become blocked (called retinal vein occlusion), which can lead to loss of vision, so people with ocular hypertension and those over 65 are often advised to keep their blood pressure below 25 mmHg. Art.

Some studies have found that the eye pressure of African Americans is, on average, higher than that of whites, while other studies have found no obvious difference.

While some studies show that women have higher intraocular pressure on average than men, other studies have not reported such a difference.

Some studies suggest that women may have a higher risk of ocular hypertension, especially after.

Studies also show that men with ocular hypertension may have a higher risk of glaucomatous injury.

With age, intraocular pressure increases and the risk of glaucoma increases. there is a huge risk of developing both ocular hypertension and primary open-angle glaucoma.

High blood pressure among young people is a cause for concern. Young people are often exposed to high blood pressure throughout their lives and are more likely to suffer damage to the optic nerve.

Causes of ocular hypertension

Increased intraocular pressure is a cause for concern for people with ocular hypertension, as it is one of the main development factors glaucoma.

High pressure inside the eye is caused by an imbalance in the production and removal of fluid from the eyes (intraocular fluid). As a consequence, more and more fluid begins to be produced, causing an increase in pressure.

Imagine a balloon being filled with water. The more water is poured, the larger the ball becomes. It is the same with an excess of intraocular fluid: the more there is, the higher the pressure. If the balloon is filled with too much water, it may burst. High pressure from excess fluid can damage the optic nerve.

Symptoms of ocular hypertension

Most people with ocular hypertension are asymptomatic. For this reason, regular checkups by an ophthalmologist are very important to repair any damage to the optic nerve due to high blood pressure.

Seeking medical attention

• Is my eye pressure high?
• Are there any signs of internal eye damage due to trauma?
• Are there any abnormalities in the optic nerve?
• Is my peripheral vision normal?
• Is treatment necessary?
• How often do I need to get tested?

Inspections and analyzes

The ophthalmologist performs tests to measure intraocular pressure to eliminate glaucoma on early stages or its secondary causes.

• First, visual acuity is assessed (how well a person can see objects around him). For this, the patient is asked to read the letters from the optometric table from a considerable distance.
• The cornea, the anterior chamber of the eye, the iris and the lens of the eye are examined under a special microscope - a slit lamp.
• Tonometry is a method used to measure intraocular pressure. Measurements are taken from both eyes in 2-3 steps. This can happen in different time day (for example, in the afternoon or evening), since the pressure inside the eye changes every hour. The difference in the pressure of both eyes is 3 mm Hg. Art. or more may suggest glaucoma. The likelihood of early primary open-angle glaucoma is high if intraocular pressure rises.
• The optic nerves are checked for any damage or abnormality through dilated pupils. For further reference and comparison, a color photograph of the fundus is taken, which captures a picture of the optic nerve head (its front surface).
• Gonioscopy is done to check the eye's excretory canal using special contact lenses. This analysis is important to determine how open, narrowed, or closed the channels are, and to eliminate any other causes of increased intraocular pressure.
• The visual field assessment procedure tests peripheral (or lateral) vision, usually with an automated visual field testing machine. The check is done to correct any defects in the visual field caused by glaucoma. You may need to repeat the procedure. If there is a small risk of glaucomatous injury, then it is worth checking only once a year. If the risk is high, then the check should be done every 2 months.
• Pachymetry (or corneal thickness) is measured with an ultrasound probe to determine the accuracy of the intraocular pressure data. A thin cornea can give a false-low pressure reading while a thick cornea can give a false-high pressure reading.

Treatment of ocular hypertension at home

If an ophthalmologist prescribes medication to lower intraocular pressure, it is very important to follow the doctor's instructions correctly, otherwise this can lead to further pressure increase, and subsequently to damage to the optic nerves and loss of vision, i.e. to glaucoma.

Therapeutic treatment

The goal of therapeutic treatment is to lower blood pressure before it causes glaucomatous vision loss. This treatment is used in people at highest risk of developing glaucoma and in people with optic nerve damage.

The ophthalmologist selects the patient's treatment method individually. Depending on the situation, a person can undergo a course of medication or simply be monitored. The doctor will discuss with the patient the pros and cons of treatment and examination:

Some ophthalmologists use local treatment to lower intraocular pressure above 21 mm Hg. Art. Others do not start treatment until damage to the optic nerve is confirmed. Most prescribe treatment if the pressure rises above 28-30 mm Hg. Art. due to the high risk of damage to the optic nerve.
The ophthalmologist will begin treatment if the patient presents with symptoms such as blurred vision, pain, or intraocular pressure continues to rise on subsequent visits.

• If any defect is found during the visual field examination, repeated (possibly multiple) examinations take place. The ophthalmologist examines the defect carefully, as it may be a sign of early primary open-angle glaucoma. This is why it is important to do your best during the procedure, as this can determine whether or not to start taking medication to lower intraocular pressure. If the patient is tired during the procedure, he should tell the specialist to suspend the test: this way the person can rest. This will give you a more accurate result.
• Gonioscopy is done at least once every 1-2 years if the intraocular pressure rises significantly or the patient is taking miotics (a type of glaucoma medication).
• If the appearance of the optic nerve or optic disc changes, more color fundus pictures (pictures of the back of the eye) are taken.

Medicines

The ideal medicine for ocular hypertension is to effectively lower intraocular pressure, not to have side effects and be inexpensive. However, there is no such ideal medicine. When choosing medications, the ophthalmologist prioritizes quality based on the characteristics of the patient's needs.

Medicines, usually in the form eye drops, are prescribed to lower increased intraocular pressure. Sometimes you need to take more than one medicine.

To test the effectiveness of eye drops, they can first be dripped into only one eye: if there are no side effects, the doctor will prescribe them.

Along with taking medications, regular visits to the ophthalmologist are prescribed. Usually, the first examination takes place 3-4 weeks after starting the medication.

The ophthalmologist checks the pressure to make sure the medication is working. If there are no side effects, then the reception continues, and a second examination occurs after 2-4 months. If the medicine is ineffective, then another one is prescribed.
The doctor may order examinations depending on the medication taken, since some of them (for example, latanoprost [Xalatan], travoprost [Travatan], bimatoprost [Lumigan]) may show results only after 6-8 weeks of taking.

During the examinations, the ophthalmologist may also examine the patient for any allergic reactions... If the patient experiences any side effects while taking the medication, he should tell his doctor about it.

As a rule, if the intraocular pressure does not decrease after taking 1 or 2 medications, it is possible that the patient has early primary open-angle glaucoma, and not ocular hypertension. In this case, the ophthalmologist may suggest other treatments.

Surgical intervention

Laser and surgical treatments are not commonly used to treat ocular hypertension, as the risks associated with these methods are higher than the risk of developing glaucomatous injury from ocular hypertension. However, if medication is not possible, laser surgery may be an alternative, but it is best to discuss this with an ophthalmologist.

Next steps

Depending on the magnitude of the damage to the optic nerve and the state of the intraocular pressure readings, people with ocular hypertension should be examined every 2 months, even earlier if the pressure is not checked well enough.

Glaucoma should be a concern for people who have increased intraocular pressure, but the optic nerves and visual field test results are normal, and people whose intraocular pressure is normal, but the condition of the optic nerves and the results of visual field tests are in doubt. These people should undergo a thorough examination: they are at an increased risk of developing glaucoma.

The term placed in the title of the article and served as its theme, literally translated from "medical" means increased tension (pressure from the inside) in the eye. Such precise detailing in this case is necessary because "ophthalmic hypertension", in contrast to the close synonym (see below), implies ONLY increased pressure of intraocular fluids and DOES NOT include those organic changes in the tissues and structures of the eye, which can be caused by prolonged increased IOP ( intraocular pressure) - glaucoma.

Glaucoma and ophthalmic hypertension - what is the difference?

The difference is that glaucoma is a diagnosis, and, like any diagnosis, it denotes a well-defined disease that has its causes, etiopathogenetic mechanisms and patterns of development, nosological variants (open or closed angle, primary or secondary, etc.) , prognosis and outcome. As a disease, glaucoma is a severe and intractable disease (in the later stages, as a rule, ophthalmic surgery is required); it remains to this day one of the two leading causes of acquired blindness, along with cataracts.
The symptoms of glaucoma can vary widely, but the most typical manifestations are caused by degenerative and atrophic changes in the most important tissues of the eye (retina, optic nerve head, vitreous etc.) under the influence of abnormally high pressure, for which these tissues are not designed. So, with a long-term course of glaucoma, there is usually a gradual (more or less rapid) decrease in visual acuity and quality, narrowing of its fields, pain on palpation and discomfort inside the eye, with paroxysmal flow - periodic "petrification" of the eyeball with intense pain, and others symptoms.

As for ophthalmic hypertension, this is not a disease (process), but a condition. The difference is easy to understand using the example of influenza: most often, but not always, influenza as a disease is accompanied by a febrile state (high fever), but not every rise in temperature means exactly the flu. Likewise, the state of ophthalmic hypertension is not necessarily a manifestation of the glaucomatous process; and vice versa, in some cases of glaucoma, IOP may remain within the conditional norm (normotensive glaucoma) - however, organic tissue degradation in this case proceeds procedurally and precisely according to the glaucomatous type.

Types of ocular hypertension

Increased intraocular pressure may be due to various reasons, arise against the background of various provoking factors and lead to various consequences. Accordingly, to reflect the essence and convenience of analysis, there are two main classes of ophthalmic hypertension: a) essential and b) symptomatic.

The typological term "essential" means something essential, intrinsic, inalienable. Essential ophthalmic hypertension is thus considered as an integral part of the natural aging processes of organs and tissues; occurs in people of mature and old age.
It should be noted that the phenomenon of essential ophthalmic hypertension is still not entirely clear and quite interesting (of course, only from a scientific point of view, since any patient would prefer a boring norm to the most fascinating pathology).

The fact is that after the age-related "equator" of life, less and less fluid is produced in the eye; IOP should decrease; on the other hand, the drainage system (removal of excess fluid from the eye chambers and spaces) is gradually aging, which, on the contrary, should lead to an increase in pressure. In all likelihood, evolution provides for a balance of these two processes, i.e. IOP should remain within the "working" normative interval, ensuring the safety of the visual system. However, under the influence of various reasons, the balance shifts towards one of the processes, and in most cases, outflow disturbances dominate, as a result of which physical pressure intraocular fluids.

It was found that in essential ophthalmic hypertension, the increase in IOP is, as a rule, bilateral; the processes of microcirculation of fluids, including blood circulation, change almost symmetrically in two eyes.

According to the definition, there is no specific dys- or atrophy of the retinal tissues and / or optic nerve (otherwise, glaucoma is diagnosed, and not just ophthalmic hypertension). A number of sources emphasize - and is justified by quite extensive statistics - that as further age changes the imbalance between the decrease in the secretion of intraocular fluid, on the one hand, and the increasing drainage disorders, on the other, is gradually leveled out, i.e. essential ophthalmic hypertension even without special treatment shows a tendency to spontaneous reduction: IOP is normalized.

Symptomatic ophthalmic hypertension, unlike essential, is not natural age process; it is always a consequence of external causes or conditions. Such factors may be prolonged use of certain medications, intoxication, etc.
Ocular hypertension of the symptomatic type is not considered as an independent disease and also does not cause glaucomatous organic changes in the retinal (retinal) tissue or optic nerve head; there is no characteristic narrowing of fields and a decrease in visual acuity. However, in the absence of adequate antihypertensive measures, symptomatic hypertension can become a provoking background for the development of true secondary (acquired) glaucoma with appropriate clinical picture and symptoms.

Causes of symptomatic ophthalmic hypertension

According to the etiological criterion, i.e. depending on the immediate causes, symptomatic ophthalmic hypertension is classified as follows:

• uveal - develops as a consequence inflammatory processes in ciliary body, the cornea, as well as with mixed inflammation and with Posner-Schlossmann syndrome (recurrent crises of anterior uveitis in combination with a surge in IOP);
• toxic - by definition, caused by the accumulation of toxic substances in the body (these can be lead compounds, aldehydes, etc.);
• corticosteroid - develops against the background of prolonged local or systemic use of hormone-containing medications;
• endocrine - occurs with glandular dysfunction internal secretion, especially the thyroid gland (hypo- and hyperthyroidism), as well as with Itsenko-Cushing's syndrome (hypersecretory activity of the adrenal cortex), climacteric hormonal changes in women, etc.;
• diencephalic - occurs within and against the background of inflammation meninges (the immediate cause is usually dysfunction of the hypothalamus and the associated endocrine subsystem).

Ophthalmic hypertension symptoms

Subjective sensations with ophthalmic hypertension of any origin and type, as a rule, become bursting, pulling, it's a dull pain in the eyeballs, radiating to the temples, forehead and other adjacent areas. With a relatively asymptomatic variant, increased intraocular pressure is often detected during prophylactic examinations or appeals to an ophthalmologist for completely different reasons (which once again testifies in favor of regular consultations with an observing ophthalmologist).

Diagnostics

To establish essential or symptomatic ophthalmic hypertension, it is necessary, first of all, to differentiate it from glaucoma itself, i.e. exclude the presence of changes characteristic of glaucoma. For this purpose, diagnostic methods that are standard for such cases are used:

• measurement of visual acuity (visimetry);
• examination of visual fields (perimetry);
• daily tonometry (repeated measurements of IOP during the day, which makes it possible to identify a general trend, delimiting it from random and situational fluctuations in intraocular pressure);
• tonometry under various loads (to diagnose a tendency towards reflex bursts of IOP);
• ophthalmoscopy (visual examination) of the fundus structures;
• gonioscopy (visual examination of the angle of the anterior chamber of the eye) to exclude drainage blocks;
• general study of liquid circulation in eyeball (tonography);
• tomographic examination of the tissues of the retina and the optic nerve head.

If necessary, additional studies can be assigned, both laboratory and instrumental (hormonal analysis, ultrasound, dopplerography of cerebral vessels, etc.). If there is reason to believe that an increase in IOP is a precursor or the first symptom of the development of glaucoma (at its earliest stage), ophthalmological observation in dynamics acquires the key diagnostic value - when, over time, characteristic glaucomatous changes appear. removed.

Our ophthalmological center has all the capabilities for the comprehensive diagnosis of conditions such as ophthalmic hypertension and glaucoma. Remember: timely correct diagnosis and prescribed treatment preserves vision and prevents blindness. Trust the professionals!

The ideal option for any treatment is an etiopathogenetic approach, i.e. elimination of the immediate cause of the pathology. However, such an opportunity, unfortunately, is not always there: doctors constantly have to deal with situations when the reasons are either unknown or unavoidable. Nevertheless, the history is carefully studied (for the identification of toxic factors, hormonal activity, latent inflammatory processes, etc.); if necessary, specialists of related profiles are involved in diagnostics and / or treatment.

Increased intraocular pressure is normalized by antihypertensive drugs: to date, a wide range of drugs that reduce pressure has been developed, produced and produced, and they are produced in a variety of pharmaceutical forms and have different effects. This allows the physician to precisely prescribe and adjust the therapeutic regimen within a wide range, depending on the suspected or established cause of hypertension. In particular, agents for systemic lowering of blood pressure (for example, tablet or injectable diuretics), inhibitors of the production of intraocular fluids, stimulants of blood circulation and fluid outflow, as well as drugs with a combined effect can be prescribed.

When the symptoms described above appear (a feeling of fullness in the eye, giving off pain to the temple, etc.), even if they are periodic and do not bother for long, it is very important that the patient see an ophthalmologist as soon as possible.

Ophthalmic hypertension as such is considered a transient and prognostically favorable condition, however, it is necessary to make sure that the symptoms are caused by “pure” ocular hypertension (essential or symptomatic), and not incipient glaucoma, which would set a completely different, much more serious and dangerous situation for vision generally.

The disease is widespread among the population different ages.

Pathology is diagnosed in 20% of patients over 50 years old, and the incidence among children and young people is steadily increasing. The disease does not affect visual function, and symptoms such as headaches and eye strain are extremely rare.

Nevertheless, a prolonged persistent increase in ophthalmotonus can cause serious eye pathologies and lead to complete loss of vision. The difficulty lies in the fact that the presence of this disease can only be determined by an ophthalmologist during the examination.

What is aqueous humor?

Watery moisture is a jelly-like, transparent liquid that fills the anterior and posterior chambers of the eye. The anterior chamber is located between the cornea and the iris. The second chamber of the eye is a narrow space located between the posterior wall of the iris and the ciliary muscle. The composition of the liquid resembles blood plasma, contains amino acids, glucose, immunoglobulins and proteins to nourish the tissues of the eye deprived of blood supply. The cells of the ciliary body produce aqueous humor by filtering blood plasma. From 3 to 9 ml of fluid is produced per day.

The main function of the substance is to maintain optimal indicators of intraocular pressure. Regulation of the parameter occurs due to the production and removal of fluid into the general bloodstream and its circulation through the chambers of the eye. Watery moisture first enters rear camera, then the fluid moves through the pupil to the anterior chamber, from where it enters the bloodstream. The return of the substance to the blood occurs due to its absorption in the venous canal of the sclera through the trabecular network of the eye. The canal removes 2-3 μl (microliter) of moisture per minute; if its work is disturbed, intraocular pressure rises.

The pressure inside the eye changes during the day, the difference in indicators can reach 6 mm. rt. Art. If the indicators reach 21 mm. rt. Art. and above, we are talking about ocular hypertension. With an intraocular pressure of 10 mm. rt. Art. and below, diagnose ““. Indicators of the norm - 15-16 mm. rt. Art. (with fluctuations in indicators plus / minus 3.5 mm Hg during the day).

When do they talk about increased intraocular pressure?

The results of measuring the parameter depend on many factors: respiratory rate, pulse, vascular tone, psychoemotional state of the patient. It is impossible to diagnose "ophthalmic hypertension" after one measurement. If a pathology is suspected, the doctor measures the indicators at least 3 times in the morning, and at least 3 times in the evening. If at each measurement the parameters exceed the upper limit of the norm, we can talk about the presence of ocular hypertension.

What is the difference between this pathology and glaucoma

Increased intraocular pressure and are not the same thing. Ocular hypertension occurs without pronounced symptoms and does not leave an imprint on visual function. The danger of the disease is that the pathology with a probability of 15-20% leads to the development of glaucoma.

Glaucoma is an eye disease that causes increased pressure inside the eye. Pathology differs from ophthalmic hypertension in that it causes a decrease in visual fields and damage to the optic nerve. Glaucoma can lead to blindness.

REFERENCE! Glaucoma is diagnosed 10 times less often than ocular hypertension.

Ophthalmic hypertension reasons

The pressure inside the eye increases due to a violation of the outflow of fluid from the anterior chamber through the venous canal of the sclera.

The violation develops along following reasons:

The above reasons lead only to a periodic increase in intraocular pressure, after which the indicators return to normal. The health of the visual analyzer does not deteriorate with a short-term increase in ophthalmotonus.

IMPORTANT! Persistent ophthalmic hypertension is observed only with hydrophthalmos (dropsy of the eye) -.

Symptoms

A slight periodic increase in intraocular pressure usually does not cause discomfort and deterioration of visual function.

In rare cases, patients may experience the following symptoms:

The above phenomena occur only in 25% of patients with ophthalmic hypertension, usually these symptoms are taken for signs of eye strain.

Consequences of prolonged increase in IOP

An increase in ophthalmotonus is considered a benign condition that practically does not affect visual function. However, with a persistent increase in pressure inside the eye, the risk of developing serious pathologies increases.

Possible complications:

• glaucoma;
• atrophy of the skin of the eyelids;
• omission upper eyelid;
• dystrophy and corneal ulcers;
• cataract;

Complications of ophthalmic hypertension always leave an imprint on visual function - visual acuity is impaired, fragments fall out of the field of view, night blindness develops. In advanced cases, pathology leads to atrophy of the optic nerve and, as a result, complete blindness.

Treatment methods

If ocular hypertension is recognized as a symptom of any disease, therapeutic measures are sent for therapy of the underlying disease. As a result of treatment, the pressure inside the eye returns to normal. If the pathology has developed as an independent syndrome, the ophthalmologist prescribes medications, physiotherapy or surgical treatment.

Drops

The doctor first prescribes eye drops. The drugs are aimed at regulating the production and outflow of aqueous humor, improving the nutrition of the structures of the eyeball, they carry out.

With ocular hypertension, appoint:

• Timolol;
• Travatan;
• Xalatan;
• Latanoprost;
• Pilocarpine;
• Betoptic.

Medicines are prescribed by a doctor on an individual basis. Treatment takes place at home.

IMPORTANT! Drops can cause side effects such as severe burning, headaches and arrhythmias. If symptoms appear, the use of the drug should be stopped urgently and consult a doctor.

Physiotherapy

The procedures are aimed at preventing complications and helping to normalize the outflow of fluid from the eye.

With ocular hypertension, appoint:

1. Pulse color therapy - exposure to the eyes with impulses of light of various shades. The therapy is aimed at relaxing the visual apparatus, relieves emotional stress.
2. Vacuum massage - treatment with an alternating vacuum using special glasses. Physiotherapy improves the work of the ciliary muscle, regulates blood circulation in the tissues of the eye.
3. Phonophoresis - treatment with ultrasound. The procedure is aimed at resolving edema, eliminating inflammation.

Not all patients are shown physiotherapy for the treatment of increased ophthalmotonus, the doctor decides whether the procedures are appropriate. Physiotherapy is contraindicated in the recovery period after surgical treatment eye diseases, with craniocerebral trauma, epilepsy.

Surgical intervention

The doctor prescribes an operation when persistent results have not been achieved with the help of eye drops and physiotherapy.

Microsurgical operations for ocular hypertension:

1. Goniotomy. The surgeon dissects the area where the cornea meets the iris. The operation is performed to stimulate the outflow of moisture from the anterior chamber of the eye through the scleral venous canal.
2. Trabeculectomy. During the operation, part of the eye's trabecular network is removed - the mesh structure located around the base of the cornea. The trabecular network allows fluids from the anterior chamber of the eye to enter the scleral venous canal. During the intervention, a special drainage "window" is created through which excess moisture leaves the eye under the conjunctiva.

Surgery is prescribed when the risk of serious complications increases. With timely diagnosis and proper medication, surgical intervention can be avoided.

Informative video

Exercises and useful tips how to reduce increased intraocular pressure without drops:

Increased ophthalmotonus can cause glaucoma, cataracts, and complete loss of vision. To avoid the development of pathology, it is necessary to visit an ophthalmologist annually for a routine examination and follow the recommendations. Doctors advise to refuse bad habits, play sports, walk in the air and see a doctor if you experience visual discomfort. Simple preventive measures will minimize the likelihood of ocular hypertension.

And ophthalmic hypertension

A primary disease of the organ of vision, which is mainly manifested by an increase in intraocular pressure, is called glaucoma. For this disease, the characteristic signs are a progressive narrowing of the visual fields and specific changes in the optic nerve, which ultimately lead to its atrophy. With ophthalmoplegia, there is only an increase in intraocular pressure. It is never accompanied by the changes that occur in primary glaucoma.

Types of ophthalmic hypertension

There are two types of ophthalmic hypertension: essential and symptomatic.

Essential ophthalmic hypertension predominantly develops in middle-aged and elderly people. Until now, it has not been finally established for what reasons it occurs. With age, a person's secretion of intraocular fluid decreases, and its outflow worsens. As long as both processes are balanced, intraocular pressure remains normal. When there is an imbalance between the production and the outflow of aqueous humor with a predominance of its production, intraocular pressure increases and essential hypertension of the eye develops.

With essential ophthalmic hypertension, intraocular pressure increases in both eyeballs. In the organ of vision, there are also no changes in the optic disc and visual fields. The indicators of hydrodynamics and hemodynamics are symmetrical in both eyes. The outflow of aqueous humor from the eye remains within normal limits. In most cases, essential intraocular hypertension has a stable or regressing course, since the difference in the system of production and outflow of intraocular fluid is leveled with age.

Symptomatic ophthalmic hypertension may occur as a result of any diseases of the organ of vision or the patient's body, as well as due to side effects of certain medications and toxic effects chemical substances... It is not an independent disease, but only a manifestation of some other pathology. With ophthalmic hypertension, there are no changes in the optic disc and visual fields characteristic of glaucoma. However, with a prolonged course, it may well gradually transform into secondary glaucoma with all the symptoms inherent in it.

Intraocular pressure in symptomatic ophthalmic hypertension may periodically increase, either for a short period of time, or there are prolonged increases in intraocular pressure.

There are several variants of symptomatic hypertension:

• Against the background of inflammatory processes of the eye (iritis, keratoiridocyclitis,), uveal hypertension develops. It also appears with glaucomatous crises.
• Toxic hypertension can develop under the influence of chronic intoxication with furfural, tetraethyl lead, and other chemicals.
• Corticosteroid ophthalmic hypertension develops as a result of prolonged local or general use corticosteroid drugs.
• In some diseases of the organ of vision, symptomatic endocrine and ophthalmic hypertension may occur. An increase in intraocular pressure occurs in the case of thyrotoxicosis, Itsenko-Cushing's syndrome, hypothyroidism, and with pathological menopause in women.
• Part of the symptom complex of diencephalic, namely hypothalamic disorders that occur with encephalitis, is diencephalic intraocular hypertension.

Complaints with ophthalmic hypertension

Patients suffering from intraocular hypertension complain of a feeling of distention of the eyeball, aches in one or both eyes, headache... Quite often, ophthalmic hypertension is an accidental finding in the preventive measurement of intraocular pressure and the absence of any subjective complaint of the patient.

Diagnosis of ophthalmic hypertension

Initially, in the presence of increased pressure in the eyeball, primary glaucoma should be excluded. For this purpose, the following studies are carried out:

• checking the acuity and visual fields (,);
• daily tonometry (measurement in the evening and morning hours of intraocular pressure);
• tonography (study of the hydrodynamics of the eye);
• perform various loading or unloading tests that provoke a change in intraocular pressure;
• retinal tomography (HRT), which evaluates the condition of the optic nerve head.

If there is a suspicion that an increase in intraocular pressure is caused by somatic pathology, other diagnostic tests are also performed: blood test for hormone levels, ultrasound doppler cerebral vessels and other tests. However, crucial in differential diagnosis ophthalmic hypertension and the initial one belongs to dynamic observation of the state of the organ of vision.

Ophthalmic hypertension treatment

First of all, to normalize intraocular pressure, the cause of intraocular hypertension should be eliminated. Carry out conservative treatment the main disease, identify and eliminate the effects of a toxic factor, correct the level of certain hormones, and so on. In this case, treatment is carried out in conjunction with a specialized specialist. Intraocular pressure is reduced by hypotensive instillation of drops into the conjunctival sac, oral administration of appropriate tablets (reducing the secretion of aqueous humor, improving outflow, or acting on both processes). One or another drug is chosen by an ophthalmologist, taking into account the data on the hemodynamics of the organ of vision, which are obtained as a result of a comprehensive diagnostic examination.

If the patient finds symptoms that indicate an increase in intraocular pressure, he should immediately contact an ophthalmologist. This should be done also in the case when signs of the disease appear periodically and quickly pass on their own, since in some cases, transient ophthalmic hypertension can lead to the development of secondary glaucoma. The same disease gives many complications and is difficult to treat.

Clinics of Moscow

Below are the TOP-3 ophthalmological clinics in Moscow, where you can get diagnostics and treatment of ophthalmic hypertension.