The 58-year-old Tan began to suffer from early cataracts and presbyopia more than 10 years ago, and her vision has declined in both distance and near, and her presbyopic lenses have gradually deepened. But two weeks ago, the old man’s near vision suddenly became ”
Good”, and can even thread a needle. She thought she had “regained her youth”. Unfortunately, 1 week ago, Tan’s right eye suddenly became red, swollen and painful, and her vision dropped sharply, so she went to the hospital for a checkup and learned that she was suffering from an acute attack of glaucoma secondary to a swelling stage senile cataract, and was saved from blindness by the doctor’s timely treatment. Tan did not understand her condition, so she asked the doctor to give her a detailed answer – = In the human eye, right in the center of the black eye, there is a transparent biconvex disc-shaped tissue called the lens. Cataract is an eye disease in which the lens becomes cloudy from transparent to opaque, blocking light from entering the eye and causing vision loss. This lesion is like a camera lens that has become opaque due to contamination. Cortical cataract is the most common type and can be divided into four stages according to its development: primary, expansion, maturation and overmaturation. The development of lens clouding in the primary stage is slow and can last for months or even years, and some stay in this stage for a long time without development. However, if it continues to develop, it is the swelling phase, during which the thickness of the lens increases due to the full swelling of the internal fibers, and the central part becomes convex to increase the refractive power of the eye, resulting in temporary myopia. At this time, the presbyopia can be offset or partially offset by the myopia, and the elderly will feel that they can see near things more clearly than in the past, and can switch to presbyopic glasses with a lower prescription, even without wearing glasses. Later on, glaucoma develops because the thickness of the lens increases and the central part of the lens becomes convex, which causes temporary myopia in addition to making the anterior chamber of the eye shallow. If the anterior chamber becomes shallow, in severe cases, the atrial angle will be occluded and the flow of water from the atrium will be obstructed, resulting in secondary glaucoma. Therefore, if the near vision of elderly people suddenly becomes “better”, they should be alerted to the aggravation of cataracts and be closely monitored for secondary glaucoma. In addition, attention should be paid to check for diabetes. When blood glucose rises, the osmotic pressure of atrial water decreases and atrial water passively penetrates into the lens, increasing lens convexity and refractive power, which can also temporarily improve near vision. For patients with acute attacks of glaucoma secondary to cataract expansion, it is not exactly the same as the treatment of ordinary cataract or glaucoma. The main treatment is to use medication to lower the IOP to the normal range and then do surgery to remove the cataract and implant an IOL, which can usually achieve the purpose of cure. For patients with more obvious shallowing of the anterior chamber during the cataract expansion phase, but who have not yet had an acute attack of glaucoma, YAG laser iris peripheral perforation can be performed to prevent an acute attack of glaucoma.