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Choroby i dolegliwości Porady Specjalistyczne

GROŹNA JASKRA – MOŻNA Z NIĄ WALCZYĆ

Choć wzrok uznawany jest za najważniejszy ze zmysłów człowieka, często zapominamy o niego dbać. Jedną z najgroźniejszych chorób atakujących oczy jest jaskra, która trwale uszkadza wzrok. Obecnie, w skali globalnej, stanowi główną przyczynę większości przypadków nabytej ślepoty. Tymczasem można jej przeciwdziałać – odpowiednio wcześnie wykryta, może być skutecznie zatrzymana, a jej przykre objawy zniwelowane.

Jaskra to zespół jednostek chorobowych, które powodują nieodwracalny zanik nerwu wzrokowego. W konsekwencji prowadzi to do zmian w polu widzenia i upośledzenia widzenia. Ze względu na skalę zachorowalności na świecie, jest uznawana za groźną chorobę społeczną. Kluczem, by powstrzymać jej rozwój jest wczesna diagnostyka. Jedynym sposobem są więc regularne wizyty u okulisty, który będzie w stanie wykryć nawet te najbardziej niepozorne objawy. Jakie są przyczyny jaskry, czym się objawia i jak można ją leczyć?

Nierozpoznane źródło

Przyczyny jaskry mogą być bardzo różne. Zależne są od budowy oka, wady wzroku, predyspozycji rodzinnych oraz przyczyn ogólnoustrojowych związanych z innymi chorobami np. cukrzycą czy lipidemią. Jaskra dotyka często osoby cierpiące na migreny i wysokie ciśnienie tętnicze. Lekarze podkreślają, że szczególnie regularnie powinni kontrolować stan swoich oczu pacjenci, u których w rodzinie już występowały przypadki tej choroby. Niezależnie od tego, współczesna medycyna dostrzega także związek pomiędzy jaskrą a stresem, od którego w dzisiejszych czasach mało komu udaje się ustrzec. Pierwsze objawy najczęściej pojawiają się około 40 roku życia, a ryzyko zachorowania zwiększa się niestety wraz z wiekiem.

Niepokojące objawy

Najbardziej ogólny podział jaskry to jaskra z szerokim, bądź wąskim kątem przesączania.

W jaskrze szerokiego kąta przez długi czas nie ma żadnych niepokojących objawów lub są one minimalne, wręcz niezauważalne. Pacjenci często je przez to lekceważą. Wówczas lekarz okulista jest pierwszą osobą, która podczas rutynowego badania jest w stanie wychwycić niewielkie odchylenia
w gałce ocznej i skierować pacjenta na dodatkowe badania, takie jak: pole widzenia, HRT, GDX, pachymetrię czy OCT tarczy nerwu wzrokowego.

W jaskrze z wąskim kątem przesączenia pacjent często cierpi na delikatne przypadłości np. widzi koła tęczy, ma okresowe zamglenia widzenia oraz łzawi. Niestety, mogą wystąpić również ostre ataki charakteryzujące się bólem oczu, głowy czy znacznym obniżeniem ostrości wzroku. Skrajne przypadki prowadzą do zaburzeń ogólnoustrojowych np. wymiotów i migren. U chorych, poza rutynowym badaniem w kierunku jaskry, konieczne jest wykonanie gonioskopii.

Badania są konieczne

Choć metod leczenia jaskry jest wiele, a medycyna oferuje coraz to nowsze i skuteczniejsze metody spowolnienia choroby i minimalizowania jej skutków, nadal najważniejsza jest profilaktyka oraz jak najwcześniejsze wykrycie problemu. Jest to możliwe jedynie dzięki regularnym wizytom u okulisty i badaniom wzroku. Tylko w ten sposób można ochronić oczy przed utratą zdolności widzenia
i bólem.

Wykonywanie badań, które są praktycznie bezbolesne, jest konieczne do postawienia odpowiedniej diagnozy, a następnie monitorowania przebiegu choroby.Warto poddawać się takim badaniom, jak badanie dna oka, pola widzenia i kąta przesączania oraz ciśnienia śródgałkowego. – twierdzi doktor Barbara Potyra z Europejskiego Centrum Zdrowego Oka z Warszawie.

Leczenie

Niestety jaskra wciąż należy do chorób nieuleczalnych. Można jednak zahamować jej rozwój. Ponieważ uszkodzenia nerwu wzrokowego cofnąć się nie da, dlatego tak ważne jest, aby wykryć chorobę w jak najwcześniejszym stadium, a dzięki temu powstrzymać jej fatalne skutki. Wszystkie metody leczenia opierają się na zmniejszaniu ciśnienia śródgałkowego – poprzez podawania kropli do oczu lub wykonaniu odpowiedniego zabiegu laserowego. Ostatecznością jest operacja.

Istnieje kilka metod laseroterapii. Pierwsza z nich to Selektywna Laserowa Trabekuloplastyka (SLT), druga zaś to Mikropulsowa Laserowa Trabekuloplastyka (MLT). To precyzyjna i bezpieczna metoda, którą stosuje się najczęściej u pacjentów młodych z nietolerancją na krople, którzy chorują na jaskrę pierwotnie otwartego kąta. Zaletą tego zabiegu jest możliwość wykonania go ponownie. U osób
z wąskim kątem przesączania wskazane jest wykonanie IRT – irydotomii laserem YAG, czyli rozcięcia podstawy tęczówki, by zapobiec lub opanować ostre ataki jaskry.

Pamiętajmy, że leczenie będzie skuteczniejsze, jeżeli choroba zostanie zdiagnozowana wcześnie. Dlatego regularnie odwiedzajmy gabinet okulistyczny i badajmy nasz wzrok.

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