Diseases that cause blindness.
1. cataracts – recoverable through cataract surgery.
2. Glaucoma – not treated actively in time – blindness.
Characteristics: Onset in both eyes, one eye develops and the other eye cannot be ignored.
Urgency.
Developed countries: 50% unaware.
China: 90% unaware.
Glaucoma.
Acute closed-angle glaucoma.
Chronic closed-angle glaucoma.
Primary open-angle glaucoma.
Normal intraocular pressure glaucoma.
Secondary glaucoma.
Congenital glaucoma.
Features.
Symptoms: acute attacks with red and painful eyes, blurred vision, iridescence (looking at lights with rainbows around them), headache, nausea, vomiting.
Chronic: unawareness of vision loss.
Examination.
High intraocular pressure.
Normal intraocular pressure.
Optic nerve damage.
Visual field damage.
Misconceptions
How can it be glaucoma when the intraocular pressure is not high and is below 21 mmHg?
Correct understanding
Some glaucoma eyes have normal intraocular pressure, below 21 mmHg, but have glaucomatous optic nerve damage and glaucomatous visual field defects. It is also glaucoma.
Misconceptions
The eye does not hurt or itch, and although you know you have the disease, you can leave it untreated for a while because your vision is good.
Correct understanding
Glaucoma is a thief that steals your visual field secretly, but none of the early and middle stages will affect your vision until one day you feel the need to see a doctor, and the visual field that has been stolen, will not be restored. Regret is too late.
Misconceptions
Acute closed-angle glaucoma after laser, everything is fine, do not go to the hospital.
Correct understanding
Patients have to take medication for a period of time after laser surgery.
A review is needed to check whether the laser is effective.
Long-term review to observe changes in IOP and visual field.
Misconceptions
Glaucoma has already been operated on, no need to go to the hospital.
Correct understanding
Be sure to follow up closely at an early stage, otherwise, although the surgery can go well, it may be lost if you do not follow up after surgery.
Misconceptions
I have regular follow-ups and my IOP has dropped with medication, so I can just have my IOP measured and don’t need other tests.
Correct understanding
IOP is only one indicator of glaucoma monitoring.
The most critical thing is to monitor changes in the visual field to observe the extent of glaucomatous optic nerve damage.
Misconceptions
My IOP has been stable, so I don’t need to be rechecked, I can just keep using my medication.
Correct understanding
Some IOP-lowering medications have the phenomenon of “drifting”, which is effective for a while, but may not achieve good IOP-lowering effect after a while. Therefore, it is necessary to follow up with your doctor and not to use certain drugs for a long time.
Misconceptions
Why do you use non-contact IOP meter and GODMAN IOP at one time to measure IOP?
Correct understanding
For glaucoma screening, a non-contact IOP meter is usually used. After glaucoma surgery, a non-contact tonometer is usually used. When IOP is at critical, but sometimes GODMAN IOP is used to decide the next step in treatment. Contact tonometer is an accurate IOP measurement, but it is also affected by the thickness of the cornea. That is why corneal thickness is done.
Misconceptions
My IOP is controlled below 21mmHg, so it is considered normal.
Correct understanding
The standard of “normal” IOP varies from person to person because the IOP value at the time of onset varies. Therefore, the IOP that keeps the visual field undamaged is the normal IOP for different people. Mild <17 mmHg, moderate <15 mmHg, and severe <12 mmHg are considered normal IOP in practice.
Misconceptions
IOP returns to normal after medication, so you can stop the medication.
Correct understanding
Glaucoma patients return to normal after medication, if stopping medication IOP will still return to abnormal IOP range, so glaucoma patients should not stop medication for life.