AN EXPLANATION FOR THE EVER INCREASING GLAUCOMA DIAGNOSES
A reaction to the article ”Primary angle-closure glaucoma increasingly widespread in European-derived populations”, published in the European
Edition of the Ocular Surgery News (Volume 23, Number 8, September 2012).
_http://www.healio.com/ophthalmology/glaucoma/news/print/ocular-surgery-news-europe-edition/%7BADBE61EA-E170-490A-97A1-36947C003ABD%7D/Primary-angle-closure-glaucoma-increasingly-widespread-in-European-derived-populations
The article discusses a review published in the British Journal of Ophthalmology, where the prevalence of primary angle-closure glaucoma is
examined. It is more widespread (increasingly so in the near future) than previously thought.
The role the accommodation spasm plays in the development of glaucoma is unfortunately not mentioned.
In the same issue of the Ocular Surgery News, an article titled “Primary angle-closure glaucoma most prevalent in Asian patients but growing worldwide” is also published. Within the prevalence of the angle-closure glaucoma is dicussed; how the majority of cases are situated in Asia, but an increase in cases is also occurring worldwide. However the accommodation spasm’s influence in the matter is not brought up. _http://www.healio.com/ophthalmology/glaucoma/news/print/ocular-surgery-news-europe-edition/%7B44FC430A-43F7-42C1-866A-482966054BE1%7D/Primary-angle-closure-glaucoma-most-prevalent-in-Asian-patients-but-growing-worldwide
The accommodation spasm strains and swells the accommodation muscle (m. ciliaris, whose processus ciliares are responsible for secreting the aqueous humor). Also the lens of the eye thickens, producing stronger refraction. On top of not working in an ideal fashion, these swollen anatomical structures take up space and narrow the angle: the circulation and outflow of the aqueous humor are decreased, and the intra ocular pressure increases.
It is to be mentioned, that if the myopization starts at an early age, in a growing person the eyeball can anatomically elongate causing the angle to open up. But the later the accommodation spasm develops, the eyeball does not “give in” and the problematic situation arises.
The widespread increase in the intra ocular pressure starts to markedly increase from the early presbyopic age. At this point as the lens of the eye starts to lose its elasticity, more work is required from m. ciliaris and the accommodation strain is severely increased.As an example of the accommodation strain, the increase in the intra ocular pressure is essential.
Especially in those who are strong (latent) hyperopes, due to the greater accommodation strain, the angle is narrow and the intra ocular pressure increases as a result.
The earliest and as complete as possible correction of hyperopia, was stressed already in Panacea (1978), pp. 344-378 (especially the chapter “Prevention” on p. 371). Within Panacea’s extensive glaucoma -related discussion, is mentioned the fact, that
as long as there remains even a slight potential for hyperopia correction, the rise in intra ocular pressure can not be held as separate glaucoma.
As is known, the amount of close work has increased considerably in the last decades (eg. computers). The ensued accommodation strain and its appropriate treatment have both been neglected by the profession at large. Naturally the prevalence of glaucoma has increased.
How often one sees “unexplainably” bloodshot eyes after tiresome close work – these are then treated with a variety of different, harmless drops, to the benefit of the business!
If proper attention was paid to the issue at hand, what a service to the mankind as a whole it would be with the resulting avoidance of unnecessary treatments, perhaps including even surgeries. The writers themselves mention iridectomies failing to bring results.
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