ear

Description

Sound is a form of energy that moves through air, water, and other matter, in waves of  pressure. Sound is the means of auditory communication. The ear changes sound pressure waves from the outside world into a signal of nerve impulses sent to the brain.

Although the ear is the vertebrate sense organ that recognizes sound, it is the brain and central nervous system that "hears".

The ear consists of three basic parts

-    The outer ear.

-    The middle ear .

-    The inner ear.

Each part of the ear serves a specific purpose in the task of detecting and interpreting sound.
The outer ear serves to collect and channel sound to the middle ear. That sound pressure is amplified through the middle portion which serves to transform these vibrations into a compressed wave in the inner ear. The inner ear serves to transform the energy of a compressed wave within the inner ear fluid into nerve impulses that can be transmitted to the brain.

The outer ear consists of an earflap and an approximately 2-cm long ear canal. The earflap provides protection for the middle ear in order to prevent damage to the eardrum. Because of the length of the ear canal, it is capable of amplifying sounds with frequencies of approximately 3000 Hz. the sound is still in the form of a pressure wave, with an alternating pattern of high and low pressure regions.

The middle ear is an air-filled cavity that consists of an eardrum and three tiny, interconnected bones - the hammer, anvil, and stirrup. The eardrum is a very durable and tightly stretched membrane that vibrates as the incoming pressure waves reach it. ( the energy of the mechanical wave becomes converted into vibrations of the inner bone structure of the ear).

The inner ear is hollow, embedded in the temporal bone, the densest bone of the body. It consists of a cochlea, the semicircular canals, and the auditory nerve. The cochlea and the semicircular canals are filled with a water-like fluid. The cochlea is a snail-shaped organ that would stretch to approximately 3 cm. In addition to being filled with fluid, the inner surface of the cochlea is lined with over 20 000 hair-like nerve cells that perform one of the most critical roles in our ability to hear.  The microscopic "hairs" of these cells are structural protein filaments that project out into the fluid. The hair cells are mechanoreceptors that release a chemical neurotransmitter when stimulated. Sound waves moving through fluid push the filaments; if the filaments bend over enough it causes the hair cells to fire. In this way sound waves are transformed into nerve impulses.
Each hair cell has a natural sensitivity to a particular frequency of vibration. When the frequency of the compressional wave matches the natural frequency of the nerve cell, that nerve cell will resonate with a larger amplitude of vibration. This increased vibrational amplitude induces the cell to release an electrical impulse that passes along the auditory nerve towards the brain.

sinuses

Description

Sinuses  are referred to those hollow , air-filled cavities that are in the skull and connected to the nasal airway by a narrow hole in the bone (ostium). 

 Humans have four pair of these cavities which are often described as a unit and termed the "paranasal sinuses" .

These  four pair of sinuses are  named according to the bones within which the sinuses lie:

1. frontal sinus (in forehead) in the frontal bone .
2. maxillary sinus (behind cheeks) 

         also called the maxillary antra .It's the largest of the paranasal sinuses,  in the  maxillary bones,.

    3. ethmoid sinus (between the eyes) formed from several discrete air cells within the ethmoid bone.

    4. sphenoid sinus (deep behind the ethmoids) in the sphenoid bone at the center of the skull base under the pituitary gland.

The paranasal air sinuses are lined with mucus-secreting cells, epithelial cells and some cells that are part of the immune system (macrophages, lymphocytes, and eosinophils).


Functions of the sinuses

• Decreasing the relative weight of the front of the skull, and especially the bones of the face.
• Increasing resonance of the voice.
• Providing a buffer againt facial trauma.
• Insulation of sensitive structures like dental roots , nerves and eyes from rapid temperature fluctuations in the nasal cavity.
• Humidifying and heating of inhaled air because of slow air turnover in this region.

 Sinusitis

It's the inflammation of one or more of the paranasal sinuses and nasal passages.
 This is may be due to :
.  A pathogenic organism (virus, bacterium, or a fungus) grows within a sinus .
The sinuses contain defenses against foreign bacteria (germs). If a disruption occurs that affects the normal host defenses inside the sinuses, those defenses may allow bacteria, which are normally present in the nasal passages, to enter any of the sinuses. Once there, the bacteria may stick to the lining cells and cause a sinus infection.
.  Allergy and irritation of the sinuses such as with hay fever.
.  Irritants, such as chemicals .
. The use and/or abuse of over-the-counter (OTC) nasal sprays.
.  Illegal substances that may be snorted through the nose.

these factors cause intermittent blockage of the sinus ostium (a small orifices joined to the nasal cavity).
 If this happens, normal drainage of mucus within the sinuses is disrupted. Drainage of mucus and pus often occur when the blockage is relieved. The drainage usually goes from the nasal passages to the throat or out the nostrils.


Symptoms of sinusitis

      .   headache.
     .   facial tenderness.
     .   pressure or pain in the eyes, nose, cheek area, or on one side of the head.
     .    fever (25% of patients may have fever associated with acute sinus infection).

• cloudy, discolored , thick nasal drainage .
  .
• a feeling of nasal stuffiness
• sore throat
• cough.

Some people notice an increased sensitivity or headache when they lean forward because of the additional pressure placed on the sinuses. Others may experience tooth or ear pain, fatigue, or bad breath.

 In noninfectious sinusitis, other associated allergy symptoms of itching eyes and sneezing may be common. Nasal drainage is usually clear or whitish-colored in people with noninfectious sinusitis.


 Sinusitis is categorized as :

1. Acute sinusitis  (sudden onset) usually lasts less than 8 weeks or occurs no more than 3 times per year with each episode lasting no longer than 10 days. Medications are usually effective against acute sinusitis. Successful treatment counteracts damage done to the mucous lining of the sinuses and surrounding bone of the skull.

2. Chronic sinusitis (long term, the most common type) lasts longer than 8 weeks or occurs more than 4 times per year with symptoms usually lasting more than 20 days.



Treatment of sinusitis

.   For sinusitis caused by virus infection, no antibiotic treatment is required.
.   For sinusitis caused by bacterial infection ,Antibiotics are not helpful for patients with mild-to-moderate symptoms, so they should not be prescribed for at least the first 7 days.

 If the symptoms lasts for more than 7 days amoxicillin-clavulanate (Augmentin) is the first-line drug for treatment of a suspected bacterial sinus infection .
-(The five most common bacteria causing sinus infections are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Streptococcus pyogenes).
-In the penicillin allergic individual, cefaclor (Ceclor), loracarbef (Lorabid), clarithromycin (Biaxin), azithromycin (Zithromax), sulfamethoxazole (Gantanol), trimethoprim (Bactrim, Septra).
An effective antibiotic needs to be continued for a minimum of 10-14 days.

.   Saline nasal irrigation is often needed on an ongoing basis.

.  Decongestants as  pseudoephedrine.

.  Mucolytics as guaifenesin and  expectorants.

.   Antihistamines should be avoided unless it is felt that the sinusitis sinus infection is due to allergy, such as  from pollens, dander, or other environmental causes.

.  Topical nasal steroid spray  such as prednisone will help reduce swelling in the allergic individual without the drying that is caused by using antihistamines although both are occasionally used.

In many people, allergic sinusitis develops first, and later, bacterial infection occurs. For these individuals, early treatment of allergic sinusitis may prevent development of secondary bacterial sinusitis.

If the condition dramatically improves after 1 - 2 months, antibiotics are stopped. The patient should continue with both the steroid and saline nasal solutions. If there is no improvement after this time, surgery may be considered. For some people with chronic sinusitis, however, the condition is not curable, and the goal of treatment is to improve the quality of life.

 Home remedies

.  Drinking plenty of fluids and getting lots of rest when needed is still the best bit of advice to ease the discomforts of the common cold. Water is the best fluid and helps lubricate the mucus membranes.

·  Chicken soup does, indeed, help congestion and ache.  The studies have reported that , the ingredients in the soup may have anti-inflammatory effects. In fact, any hot beverage may have similar soothing effects from steam.

·  Ginger tea, fruit juice, and hot tea with honey and lemon may all be helpful.

·  Spicy foods that contain hot peppers or horseradish may help clear sinuses.

·  Inhaling steam 2 - 4 times a day is extremely helpful. 

 The patient should sit comfortably and lean over a bowl of boiling hot water (no one should ever inhale steam from water as it boils) while covering the head and the bowl with a towel so the steam remains under the cloth. The steam should be inhaled continuously for 10 minutes. A mentholated or other aromatic preparation may be added to the water. Long, steamy showers, vaporizers, and facial saunas are alternatives.

Rhinitis

Rhinitis  ( Nasal allergy)

An allergy is a hypersensitivity to a foreign substance that is usually harmless but produces a violent reaction in the allergy sufferer. Allergies are generally the body's effort to eliminate something it considers unsuitable.

Allergens are some of the most common allergens include pollens, dust, dust mites, fungi, bacteria, insects, mold spores, and animal dander.

Rhinitis is a chronic or acute inflammation of the mucous membrane of the nose due to viruses, bacteria or irritants. The inflammation results in the generating of excessive amounts of mucus, commonly producing the aforementioned runny nose, as well as nasal congestion and post-nasal drip.

Types of rhinitis

1. Allergic rhinitis

Allergic rhinitis is a collection of symptoms, mostly in the nose and eyes, which occur when you breathe in something you are allergic to, such as dust, dander, or pollen.

This article focuses on allergic rhinitis due to outdoor triggers, such as plant pollen. This type of allergic rhinitis is commonly called hay fever.

Causes

Hay fever involves an allergic reaction to pollen. (A similar reaction occurs with allergy to mold, animal dander, dust, and similar inhaled allergens.)

The pollens that cause hay fever vary from person to person and from region to region. Tiny, hard to see pollens more often cause hay fever. Examples of plants commonly responsible for hay fever include:

• Trees (deciduous and evergreen)
• Grasses
• Ragweed

The amount of pollen in the air can play a role in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.


Symptoms

In many ways, the symptoms of allergic rhinitis (which is another name for nasal allergies) are close to those of the common cold. However, a cold usually goes away after a few days, while allergy symptoms do not. They may last for days or weeks at a time, or may even persist year-round, depending on what your allergy triggers are.

Symptoms that occur shortly after you come into contact with the substance you are allergic to may include:

• Itchy nose, mouth, eyes, throat, skin, or any area
• Problems with smell
• Runny nose
• Sneezing
• Tearing eyes
• A hallmark sign of nasal allergies in children is what is known as the "allergic salute" This occurs when children push up on their noses with the palm of their hand in order to stop the itching or sniffles.

Symptoms that may develop later include:

• Stuffy nose (nasal congestion)
• Coughing
• Clogged ears and decreased sense of smell
• Sore throat
• Dark circles under the eyes"shiners"
• Puffiness under the eyes
• Fatigue and irritability
• Headache
• Memory problems and slowed thinking

 Nasal allergy weakens the immune system in the nasal passage because of continuous releasing of mucus and sneezing. Mucus is the defender of the nasal organ. Continuous sneezing could injure the nasal tissue and cause it becomes easily infected by bacteria or viruses. Infection of the bacteria causes the sinusitis; whereas, infection of viruses causes flu. That why, nasal allergy patients easily catch flu and have sinusitis.

Treatment

-The best treatment is to avoid what causes your allergic symptoms in the first place.
-For mild allergic rhinitis , a nasal wash can be helpful for removing mucus from the nose You can purchase a saline solution at a drug store or make one at home using one cup of warm water , half a teaspoon of salt , and pinch of baking soda.

Treatments for allergic rhinitis include:

1. ANTIHISTAMINES
. Antihistamines work well for treating allergy symptoms , especially when symptoms do not happen very often or do not last very long.

.  Antihistamines taken by mouth can relieve mild to moderate symptoms, but many can cause sleepiness.   
 Some may be bought over the counter, without a prescription. Talk to your doctor before giving these medicines to a child, as they may affect learning.

.  Newer antihistamines cause little or no sleepiness. Some are available over the counter. They usually do not interfere with learning. These medications include loratidine (Claritin) and cetirizine (Zyrtec). Other antihistamines are available by prescription.

.  Azelastine (Astelin) is a antihistamine nasal spray that is used to treat allergic rhinitis.

 

2. CORTICOSTEROIDS

. Nasal corticosteroids sprays are the most effective treatment for allergic rhinitis.
. They work best when used nonstop , but they can also be helpful when used for shorter periods of time.
. Many brands are available. You will need a prescription from your doctor. They are safe for children and adults.

3. DECONGESTANTS

. Decongestants may also be helpful in reducing symptoms such as nasal congestion.
. Nasal spray decongestants should not be used for more than 3 days.
. Be careful when using over-the-counter saline nasal sprays that contain benzalkonium chloride. These may actually worsen symptoms and cause infection.

 

4. OTHER TREATMENTS

 

. The leukotriene inhibitor Singulair is a prescription medicine approved to help control asthma and to help relieve the symptoms of seasonal allergies.
. Specific illnesses that are caused by allergies (such as asthma and eczema ) may require other treatments.

 

5. ALLERGY SHOTS

. Allergy shots (immunotherapy ) are occasionally recommended if the allergen cannot be avoided and if symptoms are hard to control . This includes regular injections of the allergen , given in increasing doses (each dose is slightly larger than the previous dose ) that may help the body adjust to the antigen.

                           

 Inflammation caused by nasal allergy and/or viral infection leads to obstruction, fluid accumulation, bacterial infection, and acute disease. If these diseases are unsuccessfully treated, a chronic state of inflammation, obstruction, and infection develops that can cause mucosal damage and, ultimately, chronic disease.

The chronic state of immunophlogosis and hyperreactivity is followed by some important sequelae as sinusitis, which is significantly associated with allergic rhinitis even during childhood and otitis media with effusion, that affects about half of children suffering from nasal allergy. Moreover, an early treatment of rhinitis can prevent the progression to asthma.



                                        
                       

2. Vasomotor rhinitis

Vasomotor rhinitis is a nonallergic condition that involves a constant runny nose, sneezing, and nasal congestion.

Causes

Vasomotor rhinitis is not caused by an infection or allergy. The exact cause is unknown. Symptoms are triggered by something that irritates the nose, such as a dry atmosphere, air pollution, spicy foods, alcohol, strong emotions, or certain medications.      Given that there are only two types of rhinitis--vasomotor and allergic--one might think that it would be easy to make a concrete diagnosis either way. However, given the need for slightly different treatment regimens and the differences in the pathology of the two kinds of rhinitis, it's important to identify your type correctly.

   If you first develop your symptoms when you're young and you're male, you're statistically more likely to have allergic rhinitis. If, on the other hand, you first develop symptoms as an adult and you're female, you're statistically more apt to have the vasomotor variety.

Symptoms

• Runny nose
• Nasal congestion (stuffy nose)
• Sneezing
• Watery nasal drainage (rhinorrhea)

Treatment

The primary treatment is simply avoiding the things that trigger your symptoms.
In some cases, decongestants or a nasal spray containing an antihistamine may help. Corticosteroid nasal sprays may be useful for some forms of vasomotor rhinitis.

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      Nasal allergy symptoms are something people with allergic asthma often have in addition to asthma symptoms. The combination can negatively affect your quality of life. Not only that, but when allergy symptoms go uncontrolled, asthma may actually get worse as well.




Home Remedies for Nasal Allergy:

1.  Make a solution of boiled minced grape fruit and lemon and add to it some honey, and drink it 2-3 times a day. This helps in curing hay fever.

2.  To get relief  from nasal congestion boil some chamomile and inhale the fumes.

3.  Eat a well balanced diet, include a lot of protein, vitamin B and C, this will help you strengthen your immune system.

4.  Ginger and garlic are among the best immunity builder so add them in your daily diet.

5.  Green tea with honey and thyme tea with a dosage of not more than 1-2 cups also helps in curing the nasal allergy.

6.  Avoid smoking cigarette, perfumes and make your home smoke free.

7.  Do not let your pet enter your bedroom.

8.  Vegetable juices (made of spinach and cabbage) taken on a daily basis for at least 10 days proves very beneficial.

9.  Cover your mattress, pillows etc. with plastic to protect it from dust mites and wash your bed covers, curtains and pillow covers in hot water.

10.  Practicing yoga is another natural way of curing it as it involves deep breathing. More people have turned to yoga to cure a variety of illness. 

Common cold

mucociliary transport system

There are three small mucosal covered the nasal bones. These are called turbinates. They increase the filtering, warming surface of each nasal cavity. Residing to the side of the nose, underneath the eyes and up into the forehead are large air pockets in the facial bones. These connect with the nasal cavity. They are called sinuses or more correctly paranasal sinuses. They are named the maxillary, ethmoid, frontal and sphenoid sinuses. The nose and the paranasal sinuses are lined with tissue which is called mucosa. The mucosa has little hairs called cilia and floating over these hairs is a layer of fluid.
 On top of the fluid layer floats a layer of mucus. The cilia beat back and forth in the fluid layer and they move or propel the mucus blanket along, out of the sinuses into the nose. The mucus blanket is then transported to the back of the throat. Under normal circumstances the mucus is swallowed. In a normal functioning nose a quart or more of fluid is generated daily, carried to the back of the nose and swallowed. materials such as dust, or bacteria become trapped in the mucus blanket and the cilia carry these to the back of the nose where they are swallowed and killed or digested when they reach the stomach. This whole system is called the mucociliary transport system
 If the mucociliary system becomes impaired, then nasal and sinus secretions stagnate. They become infected by the bacteria which are always present within the nose and infection develops, be it in the nose or the sinuses.



THE COMMON COLD

Children in day school may get as many as ten or twelve colds a year. These colds are caused by viruses. They begin with infection in the back of your nose. This is perceived as a sore throat. As a sore throat resolves, you become aware of nasal congestion. At first you have clear secretions and then as they become infected by bacteria, the secretions turn green or yellow and are blown out the front of the nose or drip down the back of the nose and throat.

Treatment of comon cold

There are hundreds of home remedies; few have been scientifically substantiated.
.  Somewhere there is a scientific paper that alleges benefit to chicken soup. 
.  There are some suggestions that vitamin C may be useful.
.  Aspirin and Motrin reduce the symptoms of being sick but may reduce the immune system's ability to fight the cold.
. The best defense system we have is the immune system. The immune system does not work when the human body is tired or stressed. In fact, in the first signs of a cold you would be well advised to go home, curl up in bed, drink lots of water and try to sleep and relax.  The intensity and duration of the cold will be reduced.
. If  nose becomes horribly stuffed, decongestants such as SudafedR are available.  Nose drops such as Afrin and NeosynephrineR,  are addictive, so they are not a good advice.
.  Antihistamines are recommended by some. Certainly, if an individual has allergic rhinitis and that is making the cold even worse, the antihistamines may be useful.
Unfortunately, antihistamines thicken your secretions and therefore impair the mucociliary transport system and so they are potentially harmful in treating the common cold. For those who are not allergic, antihistamines can only thicken secretions and will probably do little to benefit you.
. Nasal irrigation  is very useful for the common cold. You can keep the bowl filled and whenever your nose becomes impossibly congested, irrigate both sides to wash out the thick secretions. This will provide you relief and improvement for an hour or two. This may have to be repeated four to ten times a day. You will have to make your own adjustments for salt concentration, temperature and volume.
. Zinc can be an 'effective treatment' for common colds Health reporter. Taking zinc syrup, tablets or lozenges can lessen the severity and duration of the common cold.
 
 Remember that the common cold is highly contagious and if the irrigator is being shared for nasal or dental purposes, be careful not to contaminate or use others' irrigating handles.



Home Remedies For Common Cold

1. Stay away from the following food items:
- If your child is frequently down due to common cold and cough it is best you avoid the following mentioned items. Banana and milk are a strict no.
 We all know that  if children are asked to stay away from milk it worries parents to no extent. So It is a good suggestion for parents to put their children on Soy Milk; doing so, you would be giving your child the best of both worlds.
- Give grapes only in the month of February and March. Reduce the intake of tomatoes, black eyed beans, peanuts, any items made from chic pea flour.
-Another important take away for all parents is to remember "No Water for 20 minutes after consuming any fruit".
-Avoid nasty chocolates: Those nasty, sweet things are known to yield nothing but cavities, cold and cough and add unwanted calories. Chocolates are some of the worst culprits with centers consisting almost exclusively of flavored Fondant and Praline, fondant is virtually 100% sugar and pralines are just as bad.

 2.Garlic treatment:
Most of us are aware by now about garlic's usefulness as a blood thinner, antioxidant, and cancer preventive. In addition to the said garlic also does a wonder against common cold. De-skin about 5 to 6 cloves of garlic. Prepare a necklace of the 6 cloves of garlic using a normal thread and needle. Put the same around your child's neck when he/she is sleeping. The pungent garlic will do the rest.
3. One teaspoon of magic:
 A magic potion that can be made a routine is that of ginger and tea. 1 teaspoon of regular tea with 3 to 4 drops of ginger juice first thing in the morning will keep your child away from common cold.


Warning: You should exercise all precautionary measures while following instructions on the home remedies from this article. Avoid using any of these products if you are allergic to it. The responsibility lies with the you and not with the site or the writer.

 

nose

Description

The nose is an amazingly complex instrument.
The insides of our noses are not just straight hollow tubes, but are shaped specifically to regulate airflow. A smooth bony constriction in the front has a smaller diameter than a human finger. This both protects the soft inner tissue from errant fingers and may act as a de Laval nozzle, increasing airspeed inside the nasal chamber.

The nasal root is the top of the nose, forming an indentation at the suture where the nasal bones meet the frontal bone. The anterior nasal spine is the thin projection of bone at the midline on the lower nasal margin, holding the cartilaginous center of the nose.

The internal human nose is a hollow structure above the roof of the mouth. The outer portion of the nose is the part you can see.
It is made from cartilage ( a soft rubbery tissue that gives it its shape ) which is attached to the skull at the nasal bone.
 Inside, the nose is divided into two cavities, leading from each nostril, which are separated by another strip of cartilage called the septum.
The inner nasal cavity is also connected to other cavities called sinuses. At the top of the inner cavity is the olfactory bulb, which contains the receptors that collect molecules and help you smell.
 The sinuses are lined with a mucous membrane which are soft, moist tissue covered with a layer of mucous. The tissue is also covered with microscopic hairs called cilia.

. The cilia wave back and forth, moving the mucous into the nasal cavity where it can capture dust, dirt, microorganisms, and pollen. The dirt-laden mucous is then flushed out to the stomach via the back of the throat. This is the way human body prevents bacteria from entering the body when breathing through the nose.
. The mucous in the  nasal cavity also helps to warm and moisten the air you breathe in, to help prevent damage to the  lung tissue. In order to smell something, molecules from the thing we smell have to enter the nose. Everything we smell, therefore, is giving off molecules( odorants ) . Those molecules are usually small, easy to evaporate chemicals that float through the air into the nose.

Memory is often associated with smell. Smell and memory are closely linked, although experts are not sure exactly how the process works. Smell can evoke memories, and our memory of odours seems to last longer than other memories. Like sound, odour is a memory cue.


Human nose shapes

There are virtually hundreds of shapes of noses out there.
The human nose takes on various shapes and sizes depending on cultural background, genetics and any injury or fractures.
 Every nose is unique in some way, making it a key tool for personal recognition and sometimes even an individuals’ trademark. Some people may be blessed with the perfect structure while others desperately yearn for a change.

Here are some of the common frames:


1. Flat human nose shapes


 -These shapes are a distinctive feature of Asian and African American faces.

 -The nostrils are normally wide and flared with a very short bridge and rounded tip.

 -A wide septum is also common.

2. Concave human nose shapes

- These shapes are a distincitive feature of  Caucasian people.

-Characterized by a curve which depresses in the middle with a protruding tip. The inward arching is normally caused by an overly bulky and bulbous tip.

- If the curve is slight, then this shape may actually look elegant.

3. Convex human nose shapes

-These shapes are a distinctive feature of Roman people.
-The nose is curved outwards in the centre area and protrudes too far from the face.

4.  Wavy human nose shapes

-A nose can have be wavy in two ways; looking front on or from a side view.

-Usually if the construction is warped from a frontal view, this is due to some injury or deformity.

- It can arise from nasal fracture or more commonly a genetic family trait.

-Saddle nose (boxer’s nose) is characterized by a bump towards the base where the nasal bones are located, then dips in the middle area and elevates once again at the tip.

5. Straight human nose shapes

-A lineal profile is commonly associated with narrow nostrils and a pointed tip.
-A straight nose is very desirable and appealing however an overly long dorsum can diminish the quality of this asset.

Glaucoma treatments

Glaucoma Treatments

Glaucoma is commonly treated with eye drops, and surgery for some forms or when drug therapy is not effective.

There are a number of different categories of eye drops, but all are used to either decrease the amount of fluid (aqueous humor) in the eye or improve its outward flow. Sometimes doctors will prescribe a combination of eye drops.

People using these medications should be aware of their purpose and potential side effects, which should be explained by a medical professional.

Types of Medications

1. Alpha adrenergic agonists

Action  reduce aqueous humor production and increase its outflow.

Side effects Allergic reactions frequently occur with this class of medication, increased heart rate, elevated blood pressure, headaches, blurry vision, fatigue, dry mouth, and redness in or around the eye.

Examples

• apraclonidine (Iopidine)
• brimonidine (Alphagan)
• epinepherine (Gluacon and Epifrin)
• dipivefrin (Propine)

2. Beta blockers

Action work to lower eye (intraocular) pressure by decreasing the rate at which fluid flows into the eye.

Side effects may include a slow or irregular heartbeat, depression, impotence, drowsiness, double vision, and breathing problems for patients with asthma or emphysema.

Examples

• timolol (Timoptic XE Ocumeter and Timoptic)
• levobunolol (Betagan)
• carteolol (Ocupress)
• metipranolol (OptiPranolol)
• betatoxol (Betoptic)

3. Carbonic anhydrase inhibitors       (eye drops or pills )

Action  used to reduce fluid production in the eye.

Side effects may include skin rash, eye redness or irritation, headache, nausea or upset stomach, altered taste (especially with carbonated beverages), weight loss, fatigue and decreased energy.

Examples

• dorzolamide (Trusopt)
• brinzolamide (Azopt)
• acetazolamide (Diamox) – oral medication
• methazolamide (Neptazane) – oral medication

4. Miotics (cholinergic agents)

Action help increase the rate of fluid drainage from the eye.

Side effects may include red eyes, headache, and blurry or cloudy vision.

Examples

• pilocarpine (Isopto Carpine, Travatan ,Pilocar and Pilopine HS ointment)
• echothiophate (Phospholine Iodide)

5. Prostaglandin analogs

Action reduce pressure in the eye by increasing the outward flow of fluid from the eye.

Side effects may include eye redness or irritation, a change in eye color (mostly in hazel or green eyes), increase in thickness and number of eyelashes, and joint aches or flu-like symptoms.

Examples

• latanoprost (Xalatan)
• bimatoprost (Lumigan)
• travoprost (Travatan)

 6. Combinations of eye drops

 Also used to achieve better results.

 Side effects for these medications are mentioned above.

Examples

• dorzolamide and timolol (Cosopt)
• latanoprost and timolol (Xalacom)
• brimonidine and timolol (Combigen™)

                         


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Conventional Filtration Surgery

Normally, conventional filtration surgery is used as a therapy for glaucoma after other treatment strategies, such as medications and laser surgery, have failed. It is most often performed with the open-angle form of the disease. Two procedures are used almost exclusively or only for infants with congenital glaucoma. When deciding on a treatment option, an ophthalmologist will take into account the unique aspects of each person’s case, including severity of the disease, response to medication and other health issues.

                                          

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Laser Surgery

Depending in the type of procedure, laser surgery may be used for open-angle, closed-angle or neovascular glaucoma. A laser is directed toward the trabecular meshwork, the iris, ciliary body or the retina and is used in various ways to reduce eye pressure. Laser surgery is performed on an outpatient basis in an eye doctor’s office or clinic after the eye has been numbed.

glaucoma

Glaucoma   "silent thief of sight"

Glaucoma is a complicated disease in which damage to the optic nerve leads to progressive, irreversible vision loss.  (The optic nerve receives light-generated nerve impulses from the retina and transmits these to the brain, where we recognize those electrical signals as vision. Glaucoma is characterized by a particular pattern of progressive damage to the optic nerve that generally begins with a subtle loss of side vision ).

 If glaucoma is not diagnosed and treated, it can progress to loss of central vision and blindness.
Glaucoma is theThe second leading cause of blindness.

It is often, but not always, associated with increased pressure of the fluid in the eye aqueous humour( which provides nourishment to the structures in the front of the eye ).
The term 'ocular hypertension' is used for cases having constantly raised intraocular pressure (IOP) without any associated optic nerve damage. But mostely,  this elevated eye pressure  leads to damage of the eye (optic) nerve.


 In some cases, glaucoma may occur in the presence of normal eye pressure. This form of glaucoma is believed to be caused by poor regulation of blood flow to the optic nerve.

 Glaucoma affects 1 in 200 people aged fifty and younger, and 1 in 10 over the age of eighty. If the condition is detected early enough it is possible to arrest the development or slow the progression with medical and surgical means.

Types of Glaucoma

Glaucoma is actually a group of diseases. The most common type is hereditary.

• Primary Open-Angle Glaucoma
• Angle-Closure Glaucoma
• Normal-Tension Glaucoma
• Other Types of Glaucoma



1. Primary Open-Angle Glaucoma
   This is the most common form of glaucoma .

With open-angle glaucoma, the entrances to the drainage canals are clear and should be working correctly. The clogging problem occurs further inside the drainage canals, similar to a clogged pipe below the drain in a sink.

 Most people have no symptoms and no early warning signs. If open-angle glaucoma is not diagnosed and treated, it can cause a gradual loss of vision. The subsequent loss of side vision (peripheral vision) is usually not recognized. That's why it  has been nicknamed the "silent thief of sight"
This type of glaucoma is usually responds well to medication, especially if caught early and treated.

 A slow chronic increase in eye pressure is probably not painful. In contrast, there is discomfort and pain when the eye pressure increases rapidly during an acute onset or with the rapid return of glaucoma following unsuccessful glaucoma surgery. Lowering high eye pressure relieves these painful symptoms quickly.

2. Angle-Closure Glaucoma   ( closed-angle glaucoma)

This type of glaucoma is also known as acute glaucoma or narrow angle glaucoma. It is much more rare and is very different from open-angle glaucoma in that the eye pressure usually rises very quickly.
This happens when the drainage canals get blocked or covered over, like a sink with something covering the drain.
With angle-closure glaucoma, the iris is not as wide and open as it should be. The outer edge of the iris bunches up over the drainage canals, when the pupil enlarges too much or too quickly. This can happen when entering a dark room.

Symptoms of angle-closure glaucoma may include:

• Hazy or blurred vision
• The appearance of rainbow-colored circles around bright lights
• Severe eye and head pain
• Nausea or vomiting (accompanying severe eye pain)
• Sudden sight loss

In contrast with open-angle glaucoma, symptoms of acute angle-closure glaucoma are very noticeable and damage occurs quickly. If you experience any of these symptoms, seek immediate care from an ophthalmologist.


3. Normal-Tension Glaucoma  (normal-pressure glaucoma)

Normal-tension glaucoma (NTG) is a form of glaucoma in which damage occurs to the optic nerve without eye pressure exceeding the normal range. In general, a "normal" pressure range is between 10-20 mm Hg.
 The causes of NTG are still unknown. For some reason, the optic nerve is susceptible to damage from even the normal amount of eye pressure.
Those at higher risk for this form of glaucoma are:

• people with a family history of normal-tension glaucoma
• people of Japanese ancestry
• people with a history of systemic heart disease such as irregular heart rhythm.

4. Other Types of Glaucoma

Secondary Glaucom

Secondary glaucoma refers to any case in which another disease causes or contributes to increased eye pressure, resulting in optic nerve damage and vision loss.
Secondary glaucoma can occur as the result of an eye injury, inflammation, tumor, or in advanced cases of cataract or diabetes. It can also be caused by certain drugs such as steroids. This form of glaucoma may be mild or severe. The type of treatment will depend on whether it is open-angle or angle-closure glaucoma.

Pigmentary Glaucoma

Pigmentary Glaucoma is a form of secondary open-angle glaucoma. It occurs when the pigment granules that are in the back of the iris (the colored part of the eye) break into the clear fluid produced inside the eye. These tiny pigment granules flow toward the drainage canals in the eye and slowly clog them. This causes eye pressure to rise. Treatment usually includes medications, laser surgery, or conventional surgery.

Pseudoexfoliative Glaucoma

This form of secondary open-angle glaucoma occurs when a flaky, dandruff-like material peels off the outer layer of the lens within the eye. The material collects in the angle between the cornea and iris and can clog the drainage system of the eye, causing eye pressure to rise. Pseudoexfoliative Glaucoma is common in those of Scandinavian descent. Treatment usually includes medications or surgery.

Traumatic Glaucoma

Injury to the eye may cause secondary open-angle glaucoma. Traumatic glaucoma can occur immediately after the injury or years later. It can be caused by blunt injuries that bruise the eye (called blunt trauma) or by injuries that penetrate the eye.
In addition, conditions such as severe nearsightedness, previous injury, infection, or prior surgery may make the eye more vulnerable to a serious eye injury.

Neovascular Glaucoma

The abnormal formation of new blood vessels on the iris and over the eye's drainage channels can cause a form of secondary open-angle glaucoma.
Neovascular glaucoma is always associated with other abnormalities, most often diabetes. It never occurs on its own. The new blood vessels block the eye's fluid from exiting through the trabecular meshwork (the eye's drainage canals), causing an increase in eye pressure. This type of glaucoma is very difficult to treat.

Irido Corneal Endothelial Syndrome (ICE)

This rare form of glaucoma usually appears in only one eye, rather than both. Cells on the back surface of the cornea spread over the eye's drainage tissue and across the surface of the iris, increasing eye pressure and damaging the optic nerve. These corneal cells also form adhesions that bind the iris to the cornea, further blocking the drainage channels.
Irido Corneal Endothelial Syndrome occurs more frequently in light-skinned females. Symptoms can include  hazy vision upon awakening and the appearance of halos around lights. Treatment can include medications and filtering surgery. Laser therapy is not effective in these cases.

Congenital Glaucoma (Childhood Glaucoma)

Childhood Glaucoma refers to the presence of glaucoma in a child, and occurs in 1 out of every 10,000 births in the United States. Congenital glaucoma is the common term used for a glaucoma diagnosed in infancy or early childhood.
This glaucoma is caused by abnormal intraocular fluid drainage from the eye as a result of a blocked or defective trabecular meshwork (the mesh-like drainage canals in the eye). Congenital glaucoma may be due to an hereditary defect or abnormal development during pregnancy.
In other cases, an abnormal drainage system may be the result of some other disease in the eye which results in secondary glaucoma. In these cases, the glaucoma may be associated with recognizable iris (the colored part of the eye), corneal, or other eye problems.
In an uncomplicated case of congenital glaucoma, microsurgery can often correct the structural defects. Other cases are treated with medication and surgery.

Symptoms of childhood glaucoma

• light sensitivity (photophobia)
• corneal opacification (hazy gray cornea)
• enlarged eye and cornea
• epiphora (overflow of tears)
• vision loss

A cloudy cornea is the earliest and most common sign of childhood glaucoma. The healthy cornea is transparent. The loss of this transparency is caused by edema, or swelling of tissue from excess fluid. This occurs in the corneal epithelium (outermost layer of the cornea) and in the corneal stroma (middle layer of the corneal tissue). Careful inspection of the cornea may also reveal defects in its inner layer, which is further proof of a raised eye pressure (IOP).

In most cases of glaucoma affecting children under three years of age, the cornea and eye enlarges. Review of early photographs of your child may reveal the presence of glaucoma months before the diagnosis was actually made.

In addition to eye problems, secondary systemic (body) symptoms may occur. These secondary symptoms are especially common with acute glaucoma. Examples include irritability, loss of appetite, and vomiting. These symptoms may be misunderstood before the glaucoma is recognized. Young children with glaucoma are often unhappy, fussy, and poor eaters.