1.What is glaucoma?
The normal eye is under a certain pressure. When the pressure inside the eye exceeds the highest level that one’s eye can tolerate, causing a series of visual function damage such as optic nerve damage, visual field defects and vision loss, it is called glaucoma. However, with the leap forward in medicine, the definition of glaucoma has taken on a new concept. Many people with high intraocular pressure do not develop glaucoma, while some people with normal intraocular pressure can further develop progressive visual field reduction and optic nerve damage. Therefore, the average value of IOP measurement should not be used as a criterion for glaucoma diagnosis, but should be combined with other tests.
2.What causes glaucoma?
Glaucoma can be divided into two categories, primary glaucoma and secondary glaucoma, according to its cause. Patients with primary glaucoma generally have anatomical factors, such as small eyeball, short eye axis, hyperopia, shallow anterior chamber, etc. Glaucoma may be triggered by mood swings, staying too long in dimly lit areas, or reading with the head down for long periods of time. Severe cases can lead to acute grand mal seizures, which can result in permanent blindness if not treated in time. Secondary occurrence of glaucoma is mostly due to trauma, inflammation, hemorrhage, tumor, etc., which damages the structure of the atrial angle and causes the atrial fluid drainage to be obstructed and leads to an increase in intraocular pressure. In short, glaucoma is caused by the inability of the water generated in the eye to drain properly.
3.What are the symptoms of an acute attack of glaucoma?
Acute attack is usually seen in closed-angle glaucoma, which is a disease of middle age and old age, with the onset of the disease mostly above 40 years old, especially in 50-70 years old, and 24 times more in women than men. Symptoms include: eye swelling and pain, rapid loss of vision and ipsilateral migraine, even nausea, vomiting, increased body temperature and accelerated pulse, etc.; conjunctival congestion, corneal edema, extremely shallow anterior chamber, pupil enlargement, cloudy crystal, high intraocular pressure, and hard as stone eyes. Special attention should be paid to the fact that there are some glaucoma patients with high intraocular pressure, but without any symptoms, but the consequences are more serious, some patients have been blind before they are discovered, and it is too late for treatment.
4. What is the normal intraocular pressure?
Normal intraocular pressure is within the range of 11 to 21 mmHg, but because the tolerance of the optic nerve to intraocular pressure is different for each person, some people have higher than normal intraocular pressure without damage to the optic nerve and visual field, which is called high intraocular pressure and cannot be glaucoma; other people have glaucomatous optic nerve damage and visual field defects, but the intraocular pressure is within the normal range, which is called normal intraocular pressure glaucoma or low intraocular pressure glaucoma. . Therefore, high IOP is not always glaucoma, and normal IOP does not exclude glaucoma.
5.What tests should I do when I suspect I have glaucoma?
When you suspect that you have glaucoma, you should immediately go to a hospital ophthalmology department for relevant examinations. The basic tests include: intraocular pressure, fundus examination, visual field examination and atrial angioscopy, and further tests will be done according to the above mentioned results. However, in some patients, the symptoms and signs are not obvious, so it is not easy to detect them in the early stage, and it is not easy to make a clear diagnosis immediately. This part of the population should redo all the examinations 3 months or 6 months after the first examination and compare them with the first in order to draw the correct conclusion.
6. What should I do if I have an attack of glaucoma in one eye and the other eye?
Primary closed-angle glaucoma is a bilateral disease, but it often develops in one eye first, and less often in both eyes at the same time, and the time between the two eyes is variable. Where one eye has had an acute attack, although the other eye has no history of attack, sooner or later there is the possibility of an attack, called acute angle-closure glaucoma preclinical, the literature reports that about 53% to 68% will occur acute attack, so when one eye acute attack, the other eye should also be treated. Generally, 1% pilocarpine is given 1 to 2 times/day. After recovery from surgery in the eye with an acute attack, laser iridotomy or peripheral iridotomy is possible in the other eye. When one eye is operated on, the other eye must be treated with a pupil constrictor to prevent attacks, and the eye that has not had an attack must not be taken lightly.
7. How is glaucoma treated?
Treatment of glaucoma includes medication and surgery. Medications can be applied to increase the amount of atrial fluid expelled or to decrease the amount of atrial fluid produced in the eye. Most patients can safely control their eye pressure for several years with the application of medications. Medications for glaucoma are available in many different strengths and combinations. Doctors apply a small amount of medication to produce the best therapeutic effect with the least amount of side effects. It is safe and necessary for patients to take their medications daily and strictly as prescribed to control eye pressure. Surgery is another method of treating glaucoma, including laser surgery and microsurgery.
8.What are the advantages and disadvantages of laser treatment for glaucoma?
Advantages: ①The operation is simple, fast, convenient, less painful for patients, and can be performed on an outpatient basis. ②The amount of surgery is easy to control, and laser treatment can be repeated several times.
③The laser is precise at the point of action and the adjacent tissues are less damaged. ④Light postoperative reaction, fast recovery, few complications, safe and effective. ⑤If the laser surgery fails, it does not affect the effect of further filtering surgery or other surgical treatment.
Disadvantages: ①Can not be used for all types of glaucoma. ②Postoperative medication is usually required. ③Long-term results are not certain.
9. When is the most appropriate time to operate for glaucoma?
Any tissue damage caused by glaucoma to the eye is irreversible. Generally speaking, when the IOP is elevated enough to cause visual impairment, it is time to start IOP-lowering treatment. Topical spot ophthalmic treatment is possible for early stage patients, but for patients with closed-angle glaucoma, early peripheral iridotomy or laser iridotomy can be performed with good results when the atrial angle is mostly open in the early stages. Some glaucoma is not easily controlled or often recurring, and during the examination, it is found that the color of the optic nerve in the fundus becomes lighter, the cup/disk ratio becomes larger, the visual field is defective or there is a defect in the optic nerve fiber layer found in fundus photography, etc. This indicates that the medication can no longer control the intraocular pressure, which is an indication that surgery should be performed. A large proportion of patients with glaucoma are no longer in the early stage and should be treated with surgery as soon as possible.
10.Can I improve my vision after glaucoma surgery?
Cataract surgery is a sight restoration surgery, and vision can be improved immediately after surgery, but this is not the case with glaucoma surgery. The purpose of any glaucoma surgery is to maintain the existing visual function, not to improve vision. However, some acute attacks of acute closed-angle glaucoma have a significant loss of vision, and if surgery is performed in time, vision can be improved.
11.Can glaucoma be operated on both eyes at the same time?
Glaucoma is a disease of both eyes. Once it is detected, surgery should be performed as soon as possible before the visual function is damaged. However, some unpredictable complications may occur after surgery. Because the anatomical and physiological characteristics and pathology of both eyes are similar in the same person, intraoperative or postoperative complications are extremely similar in both eyes, so glaucoma patients must not have surgery on both eyes at the same time, otherwise, if problems occur, the patient may be blind in both eyes. Usually the more severely ill eye, or the eye that has reached an advanced stage, is done first in order to observe the problems that arise after surgery. Preventive work can be done when doing the second eye.
12.What is the relationship between blood pressure and glaucoma?
A person’s IOP is positively related to blood pressure, and when IOP rises blood pressure also rises. Generally speaking, systolic blood pressure is 6.5 to 7 times the IOP and diastolic blood pressure is 3.5 to 4 times the IOP. Therefore, normal blood pressure can maintain the stability of intraocular pressure and protect the visual function.
13.How to prevent glaucoma?
According to a sample survey of disabled people in China in 1987, glaucoma is the fourth most common eye disease causing blindness, with a blindness rate of 8.8%, due to a variety of factors such as anatomical factors, genetic factors, neurovascular system and environmental factors. Therefore, early diagnosis and early treatment to avoid glaucoma attacks as much as possible is the key to glaucoma prevention and treatment. For people at high risk of glaucoma should try to avoid the development of glaucoma is the key to glaucoma prevention and treatment. For people at high risk of glaucoma should try to avoid triggering factors by: 1. being emotionally stable, not being anxious and not losing temper; 2. ensuring sleep and not staying up late; 3. avoiding working in dark rooms and not watching movies in cinemas; 4. drinking less strong tea and coffee; 5. ensuring daily bowel movements are smooth.
14.How to detect glaucoma at an early stage?
Many patients with glaucoma, especially open-angle glaucoma, have no obvious symptoms, so it is easy to miss the disease and regret for the rest of your life. ① For those who have a family history of glaucoma, each family member should be carefully examined once, and if necessary, long-term regular observation should be done. ②Common symptoms of glaucoma: eye swelling and pain, headache, rainbow vision, vision loss. ③One eye is diagnosed with glaucoma, the other eye should be highly alert and examined as early as possible. ④ Suffering from glaucoma-related systemic diseases, such as diabetes, hypertension, hypotension, etc.; suffering from systemic diseases that can cause secondary glaucoma, such as cavernous sinus embolism and abnormal thyroid function that impede venous return to the eye. ⑤ Suffering from other eye diseases related to glaucoma, such as high myopia, high hyperopia, central retinal vein obstruction, eye trauma, cataract, inflammation, eye tumor, etc.
15.Is glaucoma curable?
Generally speaking, glaucoma cannot be cured, but it can be controlled. Once diagnosed, it requires frequent, lifelong care. Actively cooperate with your doctor and treat with strict regular medication or/and surgery so as to protect the optic nerve and preserve the visual function. However, there are a few cases of early acute angle-closure glaucoma that have been properly treated to achieve a cure from no further attacks. In addition, some secondary glaucoma can be controlled once the causative factors are removed and the intraocular pressure drops. It is worth mentioning that even though the IOP is normal, within a certain period of time, all of them should be checked in the hospital to find out the problem and deal with it in time.
16.What should I pay attention to when I know I have glaucoma?
When patients know they have glaucoma, some think they have no symptoms and don’t need medication; some only use medication when they have pain and stop it after it is relieved; others are anxious, afraid, and don’t know what to do, etc. All these are not good for treatment. Patients should not take their condition lightly, nor should they be overly nervous. First, learn as much as possible about glaucoma, which can help patients deal with physical and emotional problems during treatment; second, try to avoid glaucoma triggering factors; third, actively cooperate with the doctor, use medication strictly and regularly, and do not change the treatment plan without the doctor’s permission; fourth, go to the hospital for regular review; fifth, when symptoms such as rainbow vision, eye pain and vision loss appear, immediately Fifth, when symptoms such as iris, eye pain and vision loss appear, go to the hospital immediately for examination.
17.Does the fact that the eyes are no longer swollen and painful after medication and surgery mean that the disease is cured?
Some patients think that their eyes are no longer swollen and painful after medication and surgery, so they stop using medication and do not go to the hospital for review. This is because: firstly, many patients with glaucoma have insidious onset and slow onset, so they do not feel any pain even if their eye pressure is very high; secondly, most patients do not have painful symptoms when their eye pressure rises after glaucoma surgery; thirdly, some patients with acute closed-angle glaucoma turn to chronic stage after acute attack, and gradually tolerate pain without any symptoms or symptoms are not obvious. Therefore, we cannot judge the condition based on whether the eyes are distended or not.
In addition, glaucoma is a lifelong disease that can only be controlled and slowed down, but not cured. Even if the IOP is normalized by medication or surgery, it can fluctuate due to internal and external factors, which will eventually cause irreversible damage to visual function if not reviewed frequently or treated promptly.