1.What is glaucoma?
Glaucoma is a common eye disease that endangers human health and is currently one of the major causes of blindness. Its characteristic manifestations are sunken atrophy of the optic papilla and a characteristic narrowing of the visual field defect. Elevated intraocular pressure is the main risk factor. The increased intraocular pressure exceeds the limits of the intraocular tissues, mainly the retinal optic nerve, and causes damage to the intraocular tissues (including the cornea, iris and lens), especially the optic nerve. If effective treatment is not taken, the visual field can be completely lost and eventually lead to blindness. The blindness caused by glaucoma cannot be reversed and restored by current medical technology.
2. What is IOP?
The pressure of the contents of the eye acting on the wall of the eye is the intraocular pressure (IOP for short). Statistically, an IOP of 10-21mmHg is defined as normal IOP.
3.Does high IOP necessarily mean glaucoma?
The characteristic damage of glaucoma is the sunken atrophy of the optic papilla and the characteristic defective narrowing of the visual field. In some patients, the IOP exceeds 21 mmHg, but there is no damage to the optic nerve or visual field, so it cannot be called glaucoma. However, these patients should be followed up regularly.
4. Is it not glaucoma if the IOP is not high?
The ability to tolerate IOP is different for each person, and there are a small number of patients whose IOP does not exceed 21 mmHg, but because of their poor ability to tolerate IOP, it can also cause damage to the optic nerve and visual field, which is called normal IOP glaucoma.
5. Can I tell if I have glaucoma?
There are two types of glaucoma, acute and chronic. In acute glaucoma, there are often eye swelling, headache, blurred vision, and red and green circles around the light, mostly occurring when you are tired or stay in the dark for too long, so if you have the above symptoms, you should suspect glaucoma and need to go to the hospital for examination.
Another type of glaucoma is chronic glaucoma, which is often asymptomatic in the early stage of its onset, and when vision loss is detected, it is already in the late stage of glaucoma, and the terrible thing is that this damage is irreversible. According to studies, 90% of patients with chronic glaucoma do not know they have the disease in the early stages and are not treated. For people who lack general knowledge of glaucoma prevention and treatment, they usually cannot judge themselves and need to rely on specialized consultations and examinations by ophthalmologists to confirm the diagnosis. It is necessary for people over 40 years of age to have an annual eye examination routinely.
6. Is good vision not glaucoma?
In the early stage of glaucoma, the damage may only be manifested as visual field defects, and a large proportion of patients with chronic glaucoma can still have a central vision of 0.8-1.0 in the late stage of the disease, but the visual field has been significantly reduced, and some people can’t even take care of themselves.
7.Who is prone to glaucoma?
Glaucoma prevention is important, and special attention should be paid to the following people.
People who have a family history of glaucoma
Elderly people who were farsighted when they were young
Young people with high myopia
People with a history of ocular trauma, especially those who have had high eye pressure after the injury
People with a history of hypertension or diabetes
People who are anxious or worried in nature
●Patients with elevated eye pressure or enlarged or asymmetrical cup/disc found during physical examination
●Patients who have migraine
The above patients, especially those over 40 years of age, should have an eye examination, and should be reviewed regularly even if the examination is normal. If obvious anatomical abnormalities (e.g., short eye axis, thick crystals, shallow anterior chamber) or IOP abnormalities are found then further examinations such as 24-hour IOP check, provocation test, OCT, and UBM are recommended.
8. Can glaucoma occur in infants and children?
Glaucoma can occur in infants and young children. It is a form of glaucoma related to congenital development and should not be ignored because it is more dangerous. If a newborn or infant’s eyeballs look larger than normal, and they often appear photophobic, tearful, and don’t open their eyes outdoors, don’t take it for granted that your child has big, beautiful, lovely eyes, but ask your doctor for an examination to rule out the possibility of congenital glaucoma.
9. Can glaucoma be cured?
Glaucoma is an irreversible and blinding eye disease, which means that the cure for glaucoma is to effectively control the disease from progressing further as the treatment purpose. If the patient’s visual function is already significantly impaired at the time of the initial visit, it is unlikely to return to normal, even if the IOP is well controlled.
However, early detection, timely and reasonable treatment, and control of IOP in the ideal range, most patients can maintain good visual function during their lifetime.
10.How should glaucoma be treated? What are the treatment methods?
The basic treatment principles for glaucoma are 1. to lower the intraocular pressure and 2. to protect the optic nerve. Especially, the first one is more important.
For primary open-angle glaucoma and hypertension, which are easily controlled in the early stages, topical treatment with eye drops is commonly used. If eye drops are not effective in lowering IOP, other treatments, including laser therapy and surgery, should be used.
For closed-angle glaucoma and congenital glaucoma, early surgery should be performed, and drug treatment is an adjunct.
11.What should I pay attention to with drug treatment?
If medication is applied, it is necessary to follow the doctor’s orders and use medication regularly. The following points should be noted in particular.
① Should I use medication? Can you stop the medication or when to stop it? Do you need to use one drug or several drugs at the same time? You should consult with your ophthalmologist, do not take matters into your own hands, otherwise there will be endless problems.
It is best to have two sets of eye drops ready for emergencies. Take them with you when you go on business trips or travel.
③ Press the inner corner of the eye after ordering the medication on time to improve the utilization rate of the medication and reduce the side effects caused by the absorption of the medication through the tear sac.
④Visit the hospital regularly for review to prevent glaucoma from getting worse.
⑤ Some anti-glaucoma drugs have side effects. For example, thimerosal can slow down the heart rate and cause bronchial smooth muscle contraction, so it is better not to use it if you have bradycardia, bronchial asthma and respiratory obstructive diseases, and you should be careful of the side effects when you must use it. Acetazolamide should be used with caution in patients with ureteral stones, and not for those who are allergic to sulfonamide, and the drug has the effect of potassium excretion, so the drug should be supplemented with potassium. Do not use hypertonic agents in the cardiovascular system, renal dysfunction, and glycerol is prohibited for diabetics. In short, you should explain the systemic disease to the doctor before using the drug, so that the doctor can choose the drug.
12.What are the main surgical procedures for glaucoma?
The main reason for elevated intraocular pressure is the difficulty of atrial fluid drainage and excessive water accumulation in the eye, so surgery mainly works by promoting the outward drainage of atrial fluid or reducing the entry of atrial fluid into the eye.
The main methods of surgery are: (1) establishing a new pathway for intraocular atrial water flow, including establishing a new pathway between the anterior and posterior chambers of the eye (e.g., peri-iridotomy) and establishing a new pathway for extraocular atrial water flow (filtering procedures such as trabeculectomy and atrial drainage implantation). ② unblocking the original atrial aqueous outflow pathway (anterior atrial angle dissection, atrial angle dissection, trabeculotomy) ③ reducing atrial aqueous production (ciliary cryopexy, diathermy, and photocoagulation)
13. What is the success rate of glaucoma surgery?
Glaucoma surgery itself is not complicated, but each person’s response to the surgery and their ability to heal differently, and some patients may have their intraocular pressure rise again after surgery due to the healing of the filter tract. The success rate of surgery in the better hospitals is around 80%. Therefore, everything is not fine after glaucoma surgery, and close follow-up is also necessary, because even if the surgery is very successful, a small number of patients may still have elevated IOP, which requires a combination of medication or further surgery.
14.Does glaucoma surgery have any effect on vision?
First of all, glaucoma surgery is a surgery to protect the visual function, it aims to avoid further damage, it cannot improve the visual acuity or visual field by itself, there may be a mild decrease in visual acuity for a short time, mainly because of post-operative astigmatism, but it will gradually recover.
15.What should I pay attention to before glaucoma surgery?
① Eliminate psychological tension. Glaucoma surgery is a common surgery in ophthalmology. If no serious complications occur, the surgery is short and less painful, and there is no special feeling after the surgery.
②Eating and sleeping should be regular.
③Patients with hypertension, diabetes and respiratory diseases should try to perform surgery after their condition is stabilized if the IOP can be controlled.
④Please wash your hair and do not use any eye cosmetics the day before or on the day of surgery.
⑤ A family member must accompany you on the day of surgery. Listen carefully to the doctor’s explanation of the condition, prognosis, surgical method and possible complications. Read and sign the informed consent form carefully.
16.What should I pay attention to during glaucoma surgery?
①Do not cough during surgery, as coughing will increase the intraocular pressure, which is not good for the surgery.
②Do not move your head or chat during surgery, otherwise it will affect the operation of the surgeon. If you have any pain, chest tightness or other discomfort, please inform the surgeon.
17.What should I pay attention to after glaucoma surgery?
①There is usually no pain and other reactions on the day of surgery. Some patients have slight eye grinding and eye redness, which are normal. If you have symptoms such as eye swelling and pain or even headache and nausea, you should consult your doctor promptly.
②Some patients may have numbness in their fingers after taking the medication, please do not worry.
③On the day of surgery, please do not open the bandage by yourself and try to rest quietly.
④Pay attention to eye hygiene, do not rub your eyes, move around lightly after surgery, reduce bending down, do not cough and keep your bowels open.
⑤ Avoid spicy food, do not smoke or drink.
(6) Wash your face and shower gently and do not let water run into your eyes.
(7) Observe the follow-up time, order the medication on time, and consult the doctor if there is any discomfort.
(8) Please wash your hands first when ordering eye drops. When more than two kinds of eye drops are used, they should be separated by 5 to 10 minutes, and they should not be ordered at night when sleeping.
18.What are the main risks and complications of glaucoma surgery?
Glaucoma surgery is a relatively mature procedure, most of which is safe and effective, but a very small number of patients may have anesthesia and cardiovascular accidents, infection, explosive choroidal hemorrhage, intraoperative or postoperative retinal detachment, and other problems. A small number of patients may have strong or poor filtration and thus high or low IOP. Once these complications occur, patients should maintain a good attitude and actively cooperate with treatment.
19.Notice for daily treatment and life of glaucoma patients
First, if you have glaucoma, don’t be afraid, but you must take it seriously.
Secondly, the diagnosis and treatment of glaucoma is a continuous process, and each hospital has different instruments and equipment, different treatment routines, and each doctor is always more convinced and familiar with the various test results and reports of this hospital, therefore, we advocate that patients should fix the treatment place as much as possible for the best.
Thirdly, eat a reasonable diet, eat more vegetables and fruits, and keep the bowels open. Avoid smoking, drinking strong tea and coffee, and drinking a small amount of alcohol. Avoid consuming large amounts of fluid at one time. Avoid prolonged activity in dark environments (such as cinemas). Turn on the headlights in the house when watching TV or studying at night.
Fourth, adjust your mind to reduce the anxiety and anxiety brought by the disease.
Fifth, when going to the doctor for diseases other than glaucoma, don’t forget to tell your doctor that you have a history of glaucoma and what treatment you are undergoing to facilitate the doctor’s consideration of medication to avoid using drugs that are not good for glaucoma.
Sixth, glaucoma patients should pay attention to a regular life and participate in appropriate sports activities to enhance their overall fitness and slow down the aging process of all organs in the body.
20.How to treat glaucoma correctly if you have it?
In the long-term clinical practice of ophthalmology, we have come into contact with many glaucoma patients. Some of them are pessimistic and disappointed when they hear that they have glaucoma; some of them don’t care about it because they have no obvious conscious symptoms and listen to the nature; some of them are eager to get it done and seek medical treatment everywhere, but they never carry out systematic treatment seriously; some of them even listen to the nonsense of charlatans and spend money to buy a disaster; of course, there are quite a few patients who cooperate with doctors seriously for a long time and have achieved good results in treatment. Of course, there are quite a few patients who cooperate with doctors seriously for a long time and achieve good results. We hope that more patients will join the ranks of this latter group of people. It is especially important to point out that a considerable number of patients with chronic glaucoma often gradually lose part or even all of their vision without being aware of it and fail to seek early medical attention, thus missing the time for treatment and leaving them with a lifelong regret.
How to take the prevention, diagnosis and treatment of glaucoma seriously is related to the prognosis of glaucoma. Only by proper treatment, early diagnosis and early treatment can we avoid the end of glaucoma leading to final blindness.
Glaucoma is a lifelong eye disease, and treatment of glaucoma must be persistent. As a patient, you should learn to treat glaucoma correctly, adapt to coexist with glaucoma, go to the hospital for regular checkups and receive treatment from experienced specialists.