Glaucoma is a common eye disease with a rapid onset and a high risk of blindness at any time. It is characterized by an intermittent or persistent increase in intraocular pressure that exceeds the limits of the eye’s tolerance and causes damage to various parts of the eye and visual function, resulting in optic nerve atrophy, narrowing of the visual field, loss of vision, and even blindness.
Glaucoma can be divided into three categories according to its cause: primary glaucoma, secondary glaucoma and congenital glaucoma. Primary glaucoma is divided into closed-angle glaucoma and open-angle glaucoma. Patients with closed-angle glaucoma generally have anatomical factors, such as small eye size, short eye axis, hyperopia, and shallow anterior chamber. Glaucoma can be triggered by mood swings, staying in dark places for too long, or reading with the head down for a long time, which can lead to acute grand mal seizures in severe cases and permanent blindness if not treated in time.
The onset of open-angle glaucoma is relatively insidious, and the symptoms are not obvious, so patients often discover it only after their vision has significantly decreased. Congenital glaucoma is a congenital disorder caused by poorly developed or impaired atrial angles during the development of infants and children. Secondary glaucoma is mostly due to trauma, inflammation, hemorrhage, tumor, etc., which disrupts the structure of the atrial angle and causes the atrial fluid drainage to be obstructed, resulting in elevated intraocular pressure. In short, glaucoma is caused by the inability of the water generated in the eye to drain properly.
Glaucoma is currently one of the leading blindness-causing eye diseases at home and abroad. The prevalence rate in China is 0.21-1.64%, and the blindness rate is 10-20%. This means that 10-20 out of every 100 blind people are blind due to glaucoma. Glaucoma can be prevented if it is detected and treated early, so it is essential to know something about glaucoma.
Early detection, prevention before it happens
Glaucoma is one of the major blindness-causing eye diseases, and when patients seek medical attention for symptoms, the disease has often reached a certain stage of development, with irreversible damage to visual function such as vision loss, optic nerve atrophy and visual field reduction. Therefore, early detection and treatment will greatly improve the treatment effect. So, what are the early manifestations of glaucoma?
First, emotional excitement or stay in the dark for too long (such as watching movies, television or working in a dark room), there will be eye distension, headache, blurred vision, as if there is a layer of cloud in front of the eyes, which is the early symptoms of closed angle glaucoma. This is the early symptom of closed-angle glaucoma. After repeatedly appearing for many times, it may suddenly enter the acute grand mal period.
Second, presbyopia appears before the age of 40, especially in women, and the presbyopia degree changes quickly, requiring frequent replacement of glasses. This may be related to the decrease of eye regulation and is proportional to the degree of early glaucoma lesions.
Third, it is more difficult to read books and newspapers in the morning after waking up, and it is easy to have soreness at the root of the nose and swelling of the orbital forehead. Because the IOP of normal people has a pattern of diurnal fluctuations, generally high in the morning and low at night. Glaucoma patients have a greater fluctuation of IOP over 24 hours, so the IOP is higher in the morning and symptoms will appear.
Fourth, at night, there is a colorful halo of lights, like a rainbow in the sky after a rain, which is medically called rainbow vision. This is due to the rise in intraocular pressure, corneal edema and caused by corneal refractive changes.
The vision gradually decreases, and the optometry vision is less than 1.0. Especially for highly myopic people, they often have headache and eye swelling even after wearing moderate glasses. As the sclera of high myopia becomes longer, the elasticity decreases significantly, so when high intraocular pressure appears, the self-perceived symptoms are not obvious or no symptoms, the patient is easy to neglect, while the vision is quietly lost, and the doctor is often easy to miss the diagnosis.
Sixth, headache usually occurs when drinking more water at one time. This is because drinking water quickly and in large amounts can make the blood dilute causing a decrease in osmotic pressure, and the atrial water entering the eye will increase, thus causing an increase in intraocular pressure. Patients often have a swollen eye and headache 15 to 30 minutes after drinking water.
In addition, those who have the following conditions should consider going to the hospital for glaucoma examination for early detection and early treatment.
I. 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.
Second, suffer from systemic diseases that are related to glaucoma or can cause secondary glaucoma, such as diabetes, hypertension, hypotension, cavernous sinus embolism and abnormal thyroid function.
Third, 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.
Early treatment to stop the progression of the disease in time
At present, glaucoma cannot be effectively cured, and the damage it causes to the optic nerve and visual function is irreversible. If glaucoma has been identified, early treatment should be carried out in accordance with the plan proposed by the doctor. The principles of treatment certainly vary with respect to each type of glaucoma. For primary closed-angle glaucoma and congenital glaucoma, once the diagnosis is clear, surgery must be performed as soon as possible; for secondary glaucoma, the primary disease should be treated first, and if the IOP is still high after the primary disease is controlled, surgery should be considered; as for primary open-angle glaucoma, after the diagnosis is clear, patients can choose medication or surgery according to their situation. If the IOP can be reduced to the normal range after the application of IOP-lowering drugs, and if the patient can adhere to the medication and monitor the IOP and visual function on a regular follow-up basis, medication can be chosen; otherwise, surgery should be considered.
The application of glaucoma drugs can increase the amount of atrial fluid discharge or decrease the amount of atrial fluid production in the eye. There are a variety of anti-glaucoma medications, including topical IOP-lowering drops and oral IOP-lowering medications as well as intravenous IOP-lowering medications. Oral and intravenous IOP-lowering medications should not be given for a long time because of their side effects, but only for short-term use in preparation for surgery or for acute glaucoma attacks. Medications for glaucoma are available in many different strengths and combinations. Doctors will apply a small amount of medication to produce the best therapeutic effect with minimal side effects. It is completely necessary for patients to take their medications daily and strictly as prescribed to control eye pressure.
There are also many different surgical treatments for glaucoma, including peri-iridotomy and trabeculectomy for closed-angle glaucoma; non-penetrating trabeculectomy for open-angle glaucoma; trabeculectomy and atrial angle dissection for congenital glaucoma, and valve tube implantation and ciliary cryosurgery for refractory glaucoma. Your doctor will choose the right procedure for you based on the type of glaucoma you have and your specific situation.
Although glaucoma is generally said to be incurable, with early diagnosis and timely treatment, it is entirely possible to minimize damage to visual function and maintain good vision over time. There are a few cases of early acute angle-closure glaucoma that can be basically cured with proper treatment.
Regular follow-up to consolidate the treatment effect
Some glaucoma patients no longer have swelling and pain in their eyes after medication and surgery, so they think their glaucoma has been cured and stop using medication and do not go to the hospital for review, which is very dangerous. This is because: 1. many glaucoma patients have a hidden onset, the condition is slow, even if the eye pressure is very high, there is no pain; 2. most patients do not have pain symptoms when the eye pressure rises after glaucoma surgery; 3. some acute angle-closure glaucoma, after the acute attack for a period of time into the chronic phase, the pain is gradually tolerated without any symptoms or symptoms are not obvious. Therefore, it should never be considered that glaucoma is cured if there are no symptoms.
In addition, glaucoma is a lifelong disease that can only be controlled, but not cured, and patients need lifelong treatment. Patients who are being treated for glaucoma should not be blindly optimistic, even though their condition is stable. Some anti-glaucoma medications will gradually lose their effectiveness over time, and the effectiveness of surgery will be reduced. In addition, as the optic nerve becomes less tolerant of IOP over time, the IOP needs to be lowered to a lower level. Therefore, patients with glaucoma must visit the ophthalmology department regularly to measure IOP, check the fundus, and perform visual field examinations if necessary to observe changes in their condition and adjust their treatment in a timely manner.
What can cause blindness in glaucoma patients?
Glaucoma is one of the most common blindness-causing eye diseases and causes blindness in patients due to various reasons. Common causes are as follows.
I. Open-angle glaucoma and a part of chronic closed-angle glaucoma, because there are no symptoms, patients do not know that their eyes are diseased, and once they are found to be advanced or already blind.
Second, the patient does not listen to the doctor’s advice, does not trust the doctor, does not want to do any examination, will be the best time to treat missed.
Third, they do not know enough about the danger of glaucoma and are full of care about their disease. Some people just work desperately and never see a doctor until they feel their visual field shrink, then they go to the hospital. At that time, it is often very advanced, and one eye is lost for nothing.
Fourth, can not use the medication on time, when there are symptoms on the order of drugs, no symptoms on the order of drugs, never measure the intraocular pressure, but also do not know how their eye pressure control after the order of drugs. The unreasonable use of medication delays the treatment.
V. Do not listen to the doctor’s advice. Fear of surgery, the prognosis of surgery before the operation of the doctor, can not be treated correctly, always afraid of surgery will be vision loss or even blindness, the surgery delayed again and again, until the late loss of the best treatment time.
Sixth, some patients after surgery, because the symptoms disappear, they think that glaucoma has been completely cured, and ignore the follow-up observation, regular monitoring, some patients in the postoperative blindness unknowingly.
Some patients only pay attention to the observation of intraocular pressure after surgery without checking whether the visual field has changed. Some patients have abnormal hemodynamics, such as suffering from cardiovascular disease, hypotension and increased whole blood concentration. Due to the interaction of these factors, the optic nerve is in a chronic state of insufficient blood supply for a long time, which causes progressive narrowing of the visual field and leads to blindness.
In view of some of the above, patients with glaucoma are advised that they must listen to their doctor’s advice and actively strive for early and effective treatment in order to minimize the damage to their visual function.
What should I pay attention to when I learn that I have glaucoma?
When patients learn that they have glaucoma, some think they have no symptoms and do not need to use medication; some only use medication when they are in pain and stop it after it is relieved; others are anxious, scared, and overwhelmed, etc. These are all detrimental to treatment. Patients should neither take their condition lightly, nor need to be overly nervous. The correct approach is to
A. Learn as much as possible about glaucoma, which can help patients deal with physical and emotional problems during treatment;
Second, actively cooperate with your doctor and undergo surgery as soon as possible. Patients who are not suitable for surgery should take their medication strictly and regularly, and should not change their treatment plan without the doctor’s permission;
Regular review at the hospital to understand the condition control;
When symptoms such as rainbow vision, eye pain, visual field defects and vision loss occur, go to the hospital immediately for examination.