I. Cataract
1.Talking about cataract
Cataract, especially senile cataract, is one of the most common eye diseases and is the first blindness-causing eye disease in the third world countries, accounting for 25%~50% of the blindness-causing eye diseases. According to WHO statistics, there are 15 million cataract patients in the world today, and according to our census analysis, there are about 4~5 million cataract patients waiting for surgery.
Medically, the clouding of the lens in the human eye is called a cataract. Behind the pupil, there is a small, transparent, contra-convex lens, which is called the lens. The lens is the only completely transparent convex tissue in the eye that has the ability to gather light. It gathers light from the outside world through the cornea and the pupil to the retina, forming a clear image so that people can see the colorful world. If the lens is cloudy and opaque, what you see becomes blurred, and in severe cases, you cannot see the outside world, and the pupil of the affected eye changes from black to white, so it is called cataract.
There are many types of cataracts, such as congenital, traumatic, complications and senile, among which the main one is senile cataract. In China, many people over 50 years old have different degrees of crystal clouding, and it has become common over 60 years old, and up to 90~95% over 70 years old. The occurrence of senile cataract, like the aging of human body, is still not very clear after decades of extensive research. Most scholars now recognize that cataracts are the result of a combination of factors related to age, with the initial and primary factor being oxidative damage resulting in changes in the structure of crystal proteins.
The treatment of cataracts, until today, has no real effective drug to stop the development of cataracts other than surgical treatment. Ophthalmologists have invented many effective and safe surgical procedures. IOL implantation after cataract extraction is the first functional artificial organ replacement surgery for human beings, and this surgery can enable 95% of people to obtain corrected vision of 0.5 or more after surgery.
With the development of science and technology, ultrasonic emulsification surgery is used in clinical practice. This is a kind of ultrasonic wave that is introduced into the eye to crush the cloudy and hardened crystals into a milky shape, suck them out, and then implant the IOL, which has the advantages of small incision, quick healing, no sutures, small post-operative astigmatism, and outpatient surgery.
2. Cataract surgery, no need to wait for “long maturity”
Surgery is the best way for blind people with cataracts to recover their vision, and although cataract surgery is small, it requires a high level of skill. Therefore, it is important to go to a regular hospital for regular checkups and to choose the right time for surgery after the disease.
Due to the limitation of medical technology and equipment, cataracts must be operated only when they are completely invisible (commonly known as “ripe”). Nowadays, with the development of science and technology, ophthalmic instruments and techniques have made significant progress, especially the use of ultrasound emulsification technology, which has greatly improved the success rate of cataract surgery due to the small incision, small astigmatism and good recovery of vision after surgery. Therefore, the decision to perform surgery can be made when the cataract affects the movement of daily life. Generally, those with corrected visual acuity of about 0.2 are chosen so that they basically do not affect the patient’s normal life. Some patients who need better vision for their working life can have the surgery earlier.
In order to ensure a good result, the surgeon will conduct a general examination before the surgery. The surgery is usually performed under local anesthesia, and the patient is fully aware that the doctor is operating without feeling pain.
Nowadays, many drugs in the society are advertised as being able to cure cataract, and there are also some ancestral secret recipes, new special drugs, etc. These drugs are often very expensive, and many patients often go to the hospital only after they have tried various medications and spent a lot of money and the treatment is ineffective. Since the mechanism of cataract formation is not yet clear, there is no drug that can cure or stop the development of cataract so far. I hope that cataract patients will not listen to the advertisements and turn out to be a waste of money.
Second, epidemic hemorrhagic conjunctivitis commonly known as “red eye”
The characteristics of “pink eye” are: rapid onset, short incubation period, about 24 hours onset, very contagious. Symptoms are often eye pain, foreign body sensation photophobia, lacrimation, redness in one or both eyes, a large amount of mucopurulent or plasma “eye stool”, most patients after timely treatment does not affect vision, but individual patients can cause corneal lesions, the consequences are serious. The spread of “pink eye” is mainly through contact transmission, contact with the patient’s eye secretions or secretions stained water, towels, handkerchiefs, basins, toys, household items, public facilities, etc., and “pink eye” patients rubbing their eyes after shaking hands can also be infectious.
”Red eye” patients prevention and treatment methods: 1.
1, monocular disease, should prevent the healthy eye is infected, in the rinse or eye drops, head to the affected side, to prevent secretions and tears into the healthy eye. When the secretion increases, rinse the eye with saline or warm water 3 to 4 times a day to clean the secretion in the eye.
2. Use anti-inflammatory and anti-viral eye drops as prescribed by the doctor and use eye ointment before going to bed. Some patients are eager to seek medical help, once they arrive at the hospital, they ask the doctor to give anti-inflammatory injections, which is unnecessary for red eyes. Those who are photophobic can wear tinted glasses.
3, patients should be isolated in a timely manner, as little as possible to public places, utensils should be used separately, do not share items with family members. Used tissues, cotton sticks should be placed separately in plastic bags sealed and discarded.
4, to pay attention to hand hygiene, do not use hands and sleeves to rub eyes, before and after eye drops or rubbing eyes need to wash hands and wash the faucet switch to avoid infecting others
Prevention of healthy people
1, “red eye” during the epidemic to pay attention to hand hygiene, wash hands regularly, do not rub eyes with hands and sleeves.
2. Students should suspend eye exercises during the “pink eye” epidemic.
3. Avoid going to public places during the “pink eye” epidemic, and order anti-inflammatory eye drops after swimming to prevent it.
Glaucoma
Glaucoma is an eye disease in which the pressure inside the eye is intermittently or continuously elevated. Continuous high intraocular pressure can bring damage to all parts of the eye and visual function, and if left untreated, the visual field can be completely lost and lead to blindness. Glaucoma is one of the three major blinding eye diseases that cause blindness in humans, with a prevalence of 1% in the total population and 2% after the age of 45.
Glaucoma is clinically classified into three main categories.
1, primary glaucoma.
2, secondary glaucoma.
3, congenital glaucoma.
In clinical work, many glaucoma cases have completely lost their vision when they come to our clinic, and since the damage of glaucoma to vision is irreversible, any treatment at this time cannot restore useful vision.
Glaucoma has become one of the serious blindness-causing eye diseases in China, and it is impossible for patients to regain their sight once they lose it. He called for the popularization of glaucoma prevention and control knowledge through various channels; people over 40 should have their eye pressure measured regularly for early detection and reasonable treatment. Although the damage to vision and visual field caused by glaucoma is irreversible, as long as glaucoma patients are detected early and treated reasonably, most of them can maintain a certain level of visual function throughout their lives. At present, there are some mature methods for early diagnosis of primary open-angle glaucoma and primary closed-angle glaucoma in China, and early detection and early diagnosis can be achieved for most patients.
However, because a considerable number of patients do not have any symptoms, they are often neglected; another part of acute glaucoma patients often develop within half an hour or even ten minutes, which can be easily misdiagnosed as other eye diseases and delay treatment. There is also a significant proportion of patients with diagnosed glaucoma who do not undergo reasonable treatment. Screening for glaucoma should be included in health examinations for people over 40 years of age.
Who is at risk for glaucoma?
1.Over 35 years old
2. Relatives of glaucoma patients (family history)
3.High myopia
4.Diabetes
When should I have a comprehensive glaucoma examination?
1.At the age of 35 and 40 years old
2.Every 2-3 years after the age of 40
3. Every 1-2 years after the age of 60
If the aforementioned risk factors for glaucoma are present, screening should be done every 1-2 years after the age of 35
What is glaucoma?
Glaucoma is an abnormal increase in intraocular pressure → damage to the optic nerve → visual field loss. Glaucoma arises as a result of abnormally elevated intraocular pressure, which is usually caused by abnormalities in the eye’s pump system, where the drainage ducts are blocked or covered, and the ciliary body constantly produces atrial aqueous humor. In other words, the aqueous humor is still open while the drainage channel of the scrubber is blocked.
The excess atrial fluid that accumulates in the eye presses on the eye’s weakest point: the optic nerve at the back of the eye. The elevated intraocular pressure presses the optic nerve backward into an “optic cup” or optic nerve depression. If the intraocular pressure is too high for a long time, the optic nerve is damaged, and this damage is manifested by a gradual deterioration of vision and eventually loss of vision. Early changes in vision are very mild and do not affect central vision. Central vision is the central part of the eye that can be seen when looking forward. The peripheral vision, which is the first part to be affected, is also not easily detected by the patient.
The reason why the drainage ducts of the eye no longer work properly has not yet been found, but doctors do know that glaucoma is not contagious or life-threatening, and if diagnosed early and treated carefully, glaucoma rarely leads to blindness. One consequence of glaucoma loss of vision is usually irreversible, but early diagnosis and careful lifelong treatment can help prevent further damage to vision. Most glaucoma can be controlled with medication or surgical treatment.
Is glaucoma curable?
In general, glaucoma cannot be cured, but it can be managed. Once diagnosed, it requires frequent, lifelong care. Constant observation and treatment can control intraocular pressure, thus protecting the optic nerve and preventing damage to vision. Eye drops, oral medications, laser surgery and microsurgery have been quite successful in controlling intraocular pressure over the long term.
Many people believe that glaucoma is cured when high intraocular pressure is controlled to a safe level through medication or surgery. In fact, glaucoma is only controlled, it is not yet cured. Even if intraocular pressure has been successfully controlled with medication or surgery, routine examinations by an ophthalmologist are necessary.
How is glaucoma diagnosed?
For safe and precise reasons, ophthalmologists now check four factors before making a diagnosis of glaucoma.
Intraocular pressure, the shape and color of the optic nerve, the visual field, and the condition of the anterior chamber angle. A routine glaucoma exam often includes two of the following: an ophthalmometer and a fundoscope.
An ophthalmometer is used to measure intraocular pressure. A fundoscope is used to examine the inside of the eye, primarily to check the shape and color of the optic nerve.
If the IOP is not normal or the optic nerve is abnormal, the doctor will perform one or two special tests for glaucoma.
1. Visual field examination.
2. Anterior chamber angioscopy. These tests can easily diagnose most glaucoma.
How is glaucoma treated?
The basic measure of glaucoma treatment is the application of medications, which can either increase the amount of atrial fluid expelled or decrease the amount of atrial fluid produced in the eye. In most cases, the IOP can be safely controlled with medications for several years. Medications for glaucoma are available in many different strengths and combinations. Doctors will try to use the fewest amount of medication to produce the best treatment effect and the fewest amount of medication to produce the least amount of side effects. Medication must usually be given daily, keeping in mind that daily medication as prescribed is necessary to control eye pressure. Most medications have some side effects.
Surgical treatment. Surgery is another treatment for glaucoma, and there is always a risk of complications with any surgery. In open-angle glaucoma, surgery is considered only if the maximum dose of medication fails to control IOP or if the patient cannot tolerate the medication used to control IOP. However, early surgery is advocated for closed-angle glaucoma. For safety reasons, only one eye is usually operated on at a time.
Myopia
1. What is myopia?
Nearsightedness, also known as short-sightedness, is a condition in which you can see clearly up close but not clearly at a distance. When the eye is relaxed, the focus of parallel light rays formed by the refractive system of the eye is in front of the retina, so it is blurred to see distant targets.
2. Why does myopia occur?
So far, the cause of myopia is not clear, and may be related to a variety of factors.
(1) Genetic factors. It is generally believed that high myopia is an autosomal invisible inheritance, while low to moderate myopia is a polygenic inheritance.
(2) Developmental factors. In infancy, the eye is small and physiologically farsighted, and as it grows, the eye axis gradually lengthens and tends to become orthophoric, or myopic if it develops excessively.
(3) Environmental factors. The occurrence and development of myopia is closely related to close work, especially insufficient lighting, too close reading distance, too long reading time, unclear or too small font and poor posture are all related to the occurrence of myopia. Most of the myopia in adolescents is caused by acquired adverse environmental factors, especially the deepening of myopia caused by wearing unqualified glasses.
3.How to prevent myopia?
The human eye is most susceptible to myopic changes from childhood to developmental stage, and myopia can easily occur during school age if you do not pay attention to proper control of reading time, distance, and illumination. Therefore, during the school age, teachers and parents should teach children to develop good eye habits.
1. Correct posture;
2. Keep the distance between eyes and reading materials about 25~30cm;
3.Do not read books in a car, walking or lying in bed;
4.After 1 hour of eye use, rest for about 10 minutes and look far away;
5, bright classroom, lighting should be no glare or flicker, no reflections on the blackboard, tables and chairs of appropriate height;
6.Do not read or write in the sun or in the dark;
7.Regular vision check, if there is any abnormality, correct it in time.
If you find that your child does not see distant objects clearly, or likes to squint, it means that your child may have myopia, you should go to the hospital in time for examination. If the test result is only an adjustment spasm (pseudomyopia), you should change your reading habits and pay attention to eye hygiene to avoid the development of true myopia. If the examination determines that it is true myopia, then you should wear moderate glasses.
4.How to treat myopia?
So far, various appliances to prevent myopia have proven to be very inaccurate or even ineffective in terms of efficacy. The treatment of myopia is divided into two categories: surgical and non-surgical.
1. Optometry and prescription glasses. Wearing the right glasses is by far the most effective and safest method of correction. Depending on the actual situation, you can choose frames, contact lenses, and OK lenses.
2, corneal contact lenses, that is, contact lenses. You can choose different brands and types of soft or hard contact lenses according to your needs.
3.OK lenses.
4.Adolescent progressive lenses.
5.Excimer laser surgery. Generally speaking, it should be performed after the age of 18 and the myopia is stable for more than 1 year.
5.Will glasses get deeper and deeper?
Generally speaking, most myopia is simple myopia, which starts at school age and increases with age, and stabilizes at the age of 18-20. You should wear glasses under the guidance of an optometrist and pay attention to eye hygiene in general, the less you pay attention to your eyes, the more likely your prescription will deepen. Of course, the fitting of unqualified glasses is harmful and not beneficial. Some people’s myopia deepens after wearing glasses because they don’t pay attention to overcome bad reading habits after wearing glasses, not as a result of wearing glasses. However, if the optometry is not accurate or if you wear unqualified glasses, it can cause myopia to deepen.