Glaucoma is an important eye disease that threatens human health. Glaucoma is an important cause of blindness and vision loss in both developed and developing countries, in both urban and rural areas, and in both men and women.
The main causes of its blindness are as follows.
1, high incidence, epidemiological data show that glaucoma is second only to cataract as the main cause of vision loss in the world, in the normal population over 40 years old, one in every 50 people is a glaucoma patient. According to a conservative estimate, there are 5-6 million glaucoma patients in China, and about 400,000 to 500,000 blind people due to glaucoma;
2. The onset of glaucoma is insidious and sudden, only less than 50% of patients realize that they have the disease;
3. Glaucoma has a genetic predisposition, with 10-15% of individuals in the patient’s immediate family likely to develop glaucoma;
4. The damage to visual function caused by glaucoma is irreversible and the consequences are extremely serious;
5. Glaucoma is a lifelong disease that causes great suffering and incalculable damage to individuals, families and society. However, all these data do not indicate that having glaucoma is a terminal disease, because as long as glaucoma patients are detected early and treated reasonably, most of them can maintain useful vision during their lifetime.
Therefore, the treatment of glaucoma should be “prevention before it happens”, so that glaucoma can be detected early in the natural population, so that it can be correctly diagnosed and reasonably treated before serious damage to visual function occurs. This will reduce the suffering of glaucoma patients and ease the burden on families and society.
So, how can we “prevent the damage before it happens”? To do so, it is necessary to screen for glaucoma. Because glaucoma has the potential to quietly take away your vision, it is important to have your eyes checked regularly. So, do all people need to be screened for glaucoma? Actually, no. Only those with risk factors need to undergo specialist screening to clarify whether they are at risk of developing glaucoma.
Who are the main candidates for glaucoma screening? In other words, how can I know if I am a susceptible patient for glaucoma? This is a question that many people would like to know. Some patients say that glaucoma means high eye pressure, so it is enough to go to the hospital to test the eye pressure, as long as the eye pressure is not high, it is definitely not glaucoma; some patients think that if the doctor finds that my eye pressure is high, then my “hat” of glaucoma is fixed. In fact, this is a one-sided understanding. Because high IOP is not always glaucoma, and normal IOP does not exclude glaucoma. The distribution of IOP between normal people and glaucoma patients overlaps, which means that there may be some people with high IOP who are not glaucoma patients; there may also be people with glaucoma who do not have high or normal IOP.
In addition, a large number of clinical data have shown that optic nerve atrophy and visual field loss progressively develop in some patients even after IOP is controlled, suggesting that there are other factors involved in the development of glaucoma besides IOP. Race, age, myopia, and family history, as well as any condition that can cause inadequate blood supply to the optic nerve, such as diabetes, cardiovascular disease, and abnormal blood rheology, may be risk factors for glaucoma. Elevated intraocular pressure is not the only risk factor for the development of glaucoma, but this does not mean that IOP measurement is not important. Because, all pathological processes of experimental glaucoma and secondary glaucoma confirm that elevated IOP is an important factor in causing optic nerve and visual field damage. The higher the IOP, the greater the risk of causing optic nerve damage.
So, what kind of person is necessary to be screened for glaucoma? To address this question, we need to look at age, family history, systemic medical history, and refractive status of the eye, as the onset of glaucoma is more closely related to these factors. Therefore, the main targets of glaucoma prevention are those with risk factors. Because these people with risk factors for glaucoma can cause an increase in IOP at any time when stimulated by adverse mental factors and other triggers, it is important to exclude all harmful factors that can induce an increase in IOP in order to prevent the occurrence of glaucoma. Some types of glaucoma patients, such as primary open-angle glaucoma, primary chronic closed-angle glaucoma and juvenile glaucoma, most of them do not have any conscious symptoms, so they should pay more attention to them.
1. Age and glaucoma
Clinically, juvenile glaucoma is more likely to be misdiagnosed and underdiagnosed, especially in patients with co-morbid myopia. Parents mostly think that their children’s vision loss and progressive myopia are caused by the heavy study load, and ignore other eye diseases because they usually have no conscious symptoms and the eye appearance is basically normal. They do not know that glaucoma can promote the development of myopia, and that myopia, especially high myopia, is one of the risk factors for glaucoma. Therefore, when your child’s nearsightedness is increasing, you need to do more than just fit them with the right glasses; more importantly, you need to go to a professional ophthalmologist for a comprehensive eye exam to rule out glaucoma.
In addition, middle-aged and elderly people are also at a high risk of glaucoma, especially those over 45 years old. Do not take it lightly and get checked as soon as possible when the following conditions occur
(1) Those who often have symptoms such as headache and nausea similar to the flu, but the symptoms automatically relieve or disappear after rest;
(2) Those who often have transient blurred vision or rainbow circles around incandescent lights that cannot be explained by other causes;
(3) Unexplained visual fatigue and unexplained loss of vision, especially those who feel discomfort even after wearing glasses or changing glasses frequently;
(4) Patients with other eye diseases related to glaucoma, such as high myopia, high hyperopia, central retinal vein obstruction, eye trauma, cataract, inflammation, eye tumor, etc;
(5) Patients with systemic diseases related to glaucoma, such as diabetes, hypertension, hypotension, hyperthyroidism and cavernous sinus embolism, with symptoms such as cold extremities and vascular spasm. For the above-mentioned people, we should give a comprehensive eye examination in time and follow up regularly. If these people do develop glaucoma and do not seek medical attention in time, the optic nerve and visual field of the patient will suffer irreversible damage.
3. Family history and glaucoma
Different types of glaucoma are hereditary and familial, and the exact mode of inheritance is not yet fully understood, but is most likely polygenic and multifactorial. For example, the incidence of primary open-angle glaucoma is higher in close families, about 5% to 19%, and up to 50% in those with a family history. Although the prevalence of glaucoma in families with glaucoma is much higher than that of the average family, this does not mean that all offspring of glaucoma patients will get glaucoma, which means that even if there are congenital genetic endogenous factors, there are various unfavorable external conditions to develop the disease later in life.
Therefore, it is emphasized that people with a family history of glaucoma, especially those with glaucoma in their immediate family, such as parents and siblings, should undergo regular eye examinations for early detection. Generally speaking, people aged 35 to 40 years old can be examined every 2 to 3 years; for people over 40 years old, it is best to have an annual checkup at the hospital. In addition, when glaucoma is diagnosed in one eye, the other eye should be highly alert and examined as early as possible.
Overall, glaucoma is the second most common blindness in the world, and the severity of its blindness is noted, its early diagnosis is difficult and expensive, and its treatment is yet to be improved. Only when doctors and patients cooperate and pay attention to the prevention and health care of glaucoma, can we really kill the disease in its cradle, can we really prevent it before it happens, and can really effectively prevent blindness caused by glaucoma.