Recovery of vision after glaucoma surgery

Due to the fact that drug therapy for glaucoma has a low effectiveness, more and more specialists recommend surgical intervention when the disease is detected. However, even a successful operation does not guarantee the absence of relapses. That is why proper rehabilitation is so important. In this case, patients can count on the restoration of vision after glaucoma surgery and a reduced risk of relapse.

Features of the postoperative period

Surgery can reduce eye pressure, thereby stimulating the outflow of eye fluid, squeezing the nerve weakens, and its blood supply improves. If the examination conducted 0.5 years after the operation shows that the eye pressure has returned to normal, then the treatment was successful.

The duration of remission averages about 6 years, and the probability of relapse in a patient with operated glaucoma is 10%. This is influenced by many factors, such as:

• patient's age;
• the level of professionalism of the surgeon;
• quality of postoperative rehabilitation;
• the severity of the disease;
• the quality of the operation.

Thanks to the introduction of innovative solutions and modern techniques, surgery for glaucoma lasts no more than half an hour. This reduces the length of the patient's stay in the hospital after the procedure. The need for bed rest is practically eliminated. If earlier the hospitalization period was a week, now the patient can leave the clinic within an hour after the operation, at most after 5 hours. It depends on his condition, well-being, as well as on the type of surgical intervention. When exposed to a laser, the eye does not receive mechanical damage, so the patient can go home immediately after the intervention.

Removal of sutures is carried out only after complete healing of the tissues of the eye. It is difficult to predict the exact time. The length of the postoperative period varies from patient to patient. For some patients, suture removal may take a week, while others may take up to a month to heal. Patients who forget about scheduled examinations can take several months with stitches, which is highly undesirable. In addition, periodic examinations will allow the specialist to identify the negative consequences of the operation in time and immediately eliminate them.

Non-laser glaucoma treatment usually causes irritation, redness, and increased tearing. This is due to the fact that during the operation, the specialist makes holes so that the eye fluid can drain. Because of this, the patient's vision may be blurred for two months. After the expiration of the period, it improves to the state that it was before the operation.

Tips for speeding up recovery

The patient who has undergone surgery must be responsible for the implementation of the doctor's instructions. Recommendations after glaucoma eye surgery are as follows:

1. The eye patch, which is put on after the operation, is worn without removing it for three days. You can go outside without it only after 10 days.
2. In sunny weather, be sure to wear a hat, sunglasses or anti-glaucoma glasses with green lenses to protect your eyes from ultraviolet radiation.
3. They treat all diseases that can adversely affect vision.
4. For a month, they wash themselves exclusively with boiled water.
5. Only moderate physical activity is allowed.
6. The diet is enriched with useful substances - vitamins and minerals.
7. Take at least 8 hours a day for rest.
8. They wear special glasses or lenses if prescribed by a doctor.
9. Hygiene is carefully observed to avoid infection of the eye bladder, in which fluid accumulates.
10. When a feeling of fatigue appears in the eyes, immediately stop the activity that caused it, and take a break for 1-3 hours.
11. They sleep after back surgery, controlling the position for a week. In extreme cases, it is allowed to sleep on the side, but always opposite to where the treated eye is located.
12. In order to avoid jumps in eye pressure, it is better to sleep on a high, carefully knocked down pillow.
13. For constipation, only mild laxatives are used.

Full recovery after surgery usually takes about six months. The duration of rehabilitation is influenced by many factors, in particular, the individual characteristics of the patient's body. Some manage to recover in 3 months. Others may need a whole year.

Prohibitions and restrictions after surgery

After surgery, for a more stable remission, some restrictions are introduced into the patient's habitual lifestyle:

1. During the first 10 days it is forbidden to wash the eye. You can wash your hair after a week. In the future, you should not use folk remedies for washing or instilling the eye, unless they have been prescribed by an ophthalmologist.
2. The patient is contraindicated in physical and emotional overload - lifting weights of more than 3 kg, sports training, stress, overwork.
3. You should limit the consumption of drinks and foods containing caffeine - tea, coffee, dark chocolate.
4. It is recommended to give up bad habits at least for a while.
5. All types of work in which the patient's head is tilted down are prohibited.
6. Hypothermia and colds are harmful to the operated patient.
7. The postoperative regime imposes a ban on all types of activities that require visual strain - long-term TV viewing, computer work, reading in low light conditions. You can do all of the above for a short time and only after a week after a successful operation and no complications. During the recovery period, you should not engage in work related to small details. It requires maximum attention and causes excessive tension of the optic nerve.
8. During the first days after the intervention, excessively hot, hard and salty foods should be excluded.
9. You can not drink alcoholic and carbonated drinks, as well as any liquid in large quantities for a month after the intervention.
10. It is forbidden to drive a car for 3 weeks after the operation.
11. The use of medicines containing a component such as atropine is excluded.
12. You can not paint your eyes for a month.
13. It is necessary to exclude overheating of the head, so visiting the bathhouse, sauna and beach is temporarily prohibited.

To avoid any complications, you should adhere to all of the above rules. You can learn more about this from the video.

It will be possible to return to normal life in 1.5 months after the operation. At this time, all restrictions are removed.

Taking medications

A reliable way to treat and restore vision after glaucoma is to take medications. After surgery, the risk of infection of the eye is significantly increased. Therefore, the doctor prescribes the drug to the patient in the form of eye drops. It has an antibacterial and anti-inflammatory effect. Often a specialist prescribes pilocarpine. It normalizes the size of the pupil and protects the eye from infections.

The scheme of application of the drug involves a gradual decrease in its dosage. During the first week after the intervention, the medicine is instilled into the eye four times a day. In the second week, the drug is used three times a day, etc. Continue the course of treatment for a month. Therapy is stopped early if side effects occur.

In the postoperative period, effective drugs with an antibiotic are prescribed:

• Furacilin;
• Vitabact;
• Phloxal;
• Oftaquix;
• Levofloxacin.

To relieve inflammation and speed up healing, the following medicines are used:

• Nakloof;
• Dexamethasone;
• Diclof;
• Maxidex;
• Indocollier.

Combinations containing an antibiotic and an anti-inflammatory component such as dexamethasone are often the most effective. Among them, Maxitrol and Torbadex are the most famous.

If the attending physician has prescribed several medications at once, then it is necessary to use them with an interval of 10 minutes. For instillation of various drugs, different pipettes are used. The procedure is carried out lying on your back. In this case, it is advisable not to touch the eyelid skin and eyelashes with a pipette.

Physiotherapy

Six months after the operation, you can begin to do therapeutic exercises for the eyes. Exercises for recovery after surgery look like this:

1. The eyes are closed for 3 seconds, and then wide open. Repeat the exercise 10 times.
2. Blink frequently for 2 minutes.
3. Select any object that is outside the window. The distance to it should be about 50 cm. They concentrate on the object, simultaneously marking a point on the window glass. They shift their gaze from the object to a point on the glass. Repeat the exercise 10 times.
4. The gaze is focused on any object in front. The thumb of the hand is put forward and look at it. Then they look down. The exercise is repeated 15 times.
5. The gaze is directed to the tip of the nose, then transferred to the objects located in front, then to the bridge of the nose and again forward and to the tip of the nose.
6. You need to cover your eyes and massage the eyelids with your fingertips, lightly, without pressure. Movements should be smooth, circular.
7. They look from left to right 10-12 times. In this case, the head must be fixed in one position.
8. You should draw an imaginary line on the wall from floor to ceiling. It must run strictly vertically.
9. Perform 12-15 rotational eye movements clockwise and the same amount against.

Before you start exercising, you should consult with your doctor.

Complications after surgery

A patient who decides to have an operation on the eyeball should be aware that this is always a huge risk. But with advanced glaucoma, conservative treatments are rarely effective, and surgery is the only panacea.  

Statistics show that approximately 20% of patients who survive eye surgery experience side effects. Usually they appear in the first months after the intervention, but some may make themselves felt much later.

The main factors that influence the development of complications are:

• ignoring the patient's medical recommendations in the recovery period;
• advanced age, over 75 years;
• medical error during the operation;
• contraindications to surgical intervention were not taken into account.

The most harmless consequences during the rehabilitation period after glaucoma surgery of the eye are sensitivity to light, lacrimation, redness of the mucous membrane of the eye. These side effects usually appear in the first days after the intervention and eventually disappear without additional treatment. But if they do not disappear on their own after 10 days, then you need to seek help from an ophthalmologist.

Hyphema

So called hemorrhage in the anterior chamber of the eye. Most often, this severe complication develops after treatment of angle-closure glaucoma. It does not appear immediately - it can take several months from the day of the operation. The main factors leading to the development of pathology are:

• high intraocular pressure;
• pathology of the vessels of the eye;
• outdated technique of the operation;
• late stage glaucoma.

Hyphema treatment usually does not require hospitalization and is performed on an outpatient basis. The exception is patients with blood diseases, high intraocular pressure, as well as children under the age of 3 years. All these categories of operated patients should be observed in a hospital setting.

Therapy is carried out after determining the stage of the hyphema. In the first and second stages, the ophthalmologist prescribes simple corticosteroids. Atropine and Prednisolone drops showed high efficiency. If the diagnosis reveals stages 3 and 4 of the disease, then a second surgical intervention, called trabeculectomy, is necessary.

To wash the anterior chamber on the vitreous make 2 incisions. In one of them, the specialist introduces a crystalloid solution. It helps to remove blood clots that are expelled through the second hole. This procedure helps to reduce intraocular pressure, eliminate pupillary block and improve blood flow.

Hypotension

This pathology is characterized by a decrease in intraocular pressure. The reason for its occurrence is a violation of the tightness of the seams, which cannot be corrected. The main signs of this condition are:

• pain in the eye;
• decreased vision;
• reduction of the eye in size.

If these symptoms occur, you should immediately consult a doctor. Often, during the examination, the specialist additionally diagnoses swelling of the optic nerve and corneal folds, detachment of the retina.

To normalize the condition, stimulants and vasoconstrictor drugs are used that increase eye pressure - Atropine, Aloe, ATP preparations. Often you have to resort to hormones and injections into the vitreous body. Surgical intervention is performed if there is:

• the need to impose new seams, narrowing the drainage channel;
• detachment of the choroid;
• the need to open the suprachoroidal space for a better outflow of fluid.

If symptoms are ignored, there is a risk of such dangerous consequences as atrophic processes and subsequent corneal dystrophy.

Endophthalmitis

Inflammation of the inner membranes of the eye with the formation of pus occurs when sanitary standards are not observed during the intervention and the tissues become infected with pathological microorganisms. This could also happen due to the excessive toxicity of the antibiotic used, its ineffectiveness against the pathogen, or an incorrectly calculated dosage. Another reason lies in the mistake of the patient himself, who prematurely stopped taking the prescribed drugs in the recovery period.

When diagnosing endophthalmitis, it is recommended to do echography, which will help determine the condition of the retina and vitreous body. Sowing is carried out on the flora of the intraocular fluid and the vitreous body. The doctor prescribes injections of amikacin and vancomycin with an antibiotic into the vitreous chamber. For two days they take antibiotics, which were previously used in the form of injections. The low effectiveness of therapy, further decrease in vision and the impossibility of ophthalmoscopy force the use of vitrectomy. This is an operation to completely or partially remove the vitreous body.

Ciliochoroidal detachment

This is a common complication that often develops immediately after surgery. The condition is characterized by leakage of intraocular fluid from the vitreous body. Due to its significant deficiency, a cavity is formed under the sclera, detachment of the choroid and ciliary body occurs.

Symptoms of detachment are decreased vision, hyphema, narrowing of the eye incision, and decreased intraocular pressure. As a result, vascular pathology, clouding of the lens, secondary glaucoma, and even complete loss of vision may develop.

The causes of pathology are:

• enhanced filtration;
• decreased production of intraocular fluid,
• excessive use of drains and cytostatics.

Drugs used to treat detachment are corticosteroids, vasodilators such as pentoxifylline and cavinton, and etamsylate. Glycerin, 20% caffeine solution and 5% hypertonic solution are used by injection. If the desired effect does not occur, then supraciliary sclerotomy is used.

Scarring

With the formation of scars, even a second operation will not help. If the scar grows on the cornea, then after 2-3 years glaucoma occurs again. When the channels for the outflow of eye fluid are blocked by scars, inflammation develops. Because of this, the balance of inflow and outflow of intraocular fluid is disturbed, intraocular pressure decreases. This leads to the development of cataracts and complete loss of vision.

To reduce the likelihood of developing this pathology, it is best to choose a laser treatment method.

Visits to the ophthalmologist

The mode of visiting a specialist should be as follows:

• daily for two days after surgery;
• in 3 days;
• a week later;
• a month later;
• after 3 months;
• once a year for preventive examination.

During the examinations, the specialist can additionally prescribe medications and give recommendations for the fastest possible recovery.

If discomfort occurs - pain, decreased vision and inflammation, you need to contact an ophthalmologist unscheduled.

In order for the recovery of vision after glaucoma to go faster, and the result of the operation to be fixed, it is necessary to adhere to the recommendations drawn up by the attending physician.
Any willfulness can lead to a relapse of the disease and destroy the positive effect of the intervention. To date, there is no method that would save the patient from glaucoma forever. Treatment, including gymnastics and medication, will have to be continued for the rest of your life.