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Abstract: The patient was seen for eye distention, headache, and a slight decrease in visual acuity. Visual acuity examination was performed, which showed that the patient’s white eyes in the anterior segment were not red in color, the anterior chamber was normal in depth, the anterior chamber angle was open, the atrial angle was not adherent, the 24-hour intraocular pressure fluctuated greater than 8 mmHg, the physiological depression of the optic disc deepened and expanded, and isolated paracentral dark spots and nasal lateral steps were seen. The patient was clearly diagnosed as having primary open-angle glaucoma, and was immediately given The patient was immediately treated with medication, and the patient’s IOP returned to normal and vision was restored.
Basic information】Male, 38 years old
Disease Type】Primary open-angle glaucoma
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】January 2022
Treatment plan】Topical medication (Maurozine nitrate eye drops, Brinzolamide eye drops) + oral Chinese medicine (Prolotherapy plus reduction)
Treatment period】1 month
Effect】The patient’s IOP returned to normal and vision was restored.
I. Initial consultation
The patient had to stare at the computer all the time at work, so he often felt distended eyes and headache, and his vision was slightly reduced. The patient always thought that it was caused by excessive eye use at work, and he used eye drops, but the symptoms did not improve, and he still had distended eyes and headache after resting, so he came to the hospital.
After admission, we performed visual acuity examination, intraocular pressure test and visual field examination for the patient. The result of visual acuity examination showed that the patient’s visual acuity was 0.9 in the right eye and 1.0 in the left eye, the anterior chamber depth was normal, the anterior chamber angle was open, the atrial angle was not adherent, the intraocular pressure was 30 mmHg in the left eye and 25 mmHg in the right eye, and the fluctuation of intraocular pressure was greater than 8 mmHg for 24 hours of detection, the physiological depression of the optic disc was deepened and enlarged, and isolated paracentral The patient was clearly diagnosed as having primary open-angle glaucoma.
II. Treatment process
After the diagnosis was confirmed, the patient was immediately given IOP control, and the eye drops with brinzolamide nitrate were given to reduce the resistance to atrial outflow and increase the outflow of atrial fluid. Patients can exercise aerobically every day and reduce the time of using electronic devices to reduce the time of using eyes. At the same time, the patient was applied the Chinese herbal medicine Prosperity San with the addition of Chrysanthemum and Angelica dahurica to clear the liver, brighten the eyes and relieve pain.
III. Treatment effect
After 7 days of treatment, the patient’s intraocular pressure was maintained at 18 mmHg in both eyes, and the sensation of eye distension and headache was significantly reduced, so the patient was discharged from the hospital to recuperate and was instructed to have regular follow-up examinations. At the time of discharge, the patient was advised to regularly check his visual acuity, intraocular pressure, fundus and visual field, to avoid emotional excitement, to take rest, not to stay up late, and to keep his bowels open. After 1 month of treatment, the patient returned to the hospital for follow-up, and the IOP was stabilized at 17 mmHg. The eye distension and headache had completely disappeared and did not recur, and the recovery was good.
IV. Notes
We are glad that after active treatment, the patient’s IOP was controlled to normal and the eye discomfort and head discomfort had disappeared without recurrence, and the patient’s overall recovery was good. However, this does not mean that the patient can be done once and for all. In the follow-up daily life, the patient should also pay attention to the daily diet should be kept as light as possible, you can eat more fresh vegetables and fruits, in addition, to drink water properly, but not too much, otherwise it will also cause the IOP to rise.
In addition, it is also very important to ensure sufficient sleep. Patients should rest early every day, which can give the eyes sufficient rest and help to lower the IOP and improve the condition of glaucoma. If you are often angry or are mentally stimulated, the IOP will rise sharply, thus aggravating the condition of glaucoma, so patients should usually keep a happy mood.
V. Personal perception
Glaucoma is a disease in which the optic nerve is altered and vision is impaired because of elevated intraocular pressure. In this case, the patient used her eyes for a long time due to her work, which led to the elevation of eye pressure and the symptoms of eye distension and headache, but she mistook it for eye fatigue and delayed the treatment. However, it is good that after systematic treatment, the patient’s condition was effectively controlled and his vision improved.
Nowadays, with the development of society, there are more and more electronic products, so there are often cases of excessive use of eyes, so people should pay attention to develop good eye habits, and if there are uncomfortable symptoms, they must seek medical attention in time.