Some cataract surgery should not be delayed for long, and cataracts should be operated when they affect vision.
This is a common scene in emergency ophthalmology clinics. Why would an elderly person who is normally in good health, with only a cataract and no other eye disease, suddenly develop severe glaucoma? This has to do with the fact that not much is known about how common cataracts can turn into very serious glaucoma in some patients.
Cataracts are an extremely common eye disease that severely affects vision, and now, thanks to advances in technology, they can be completely cured through surgery. However, glaucoma is a different story. It is a very serious blinding eye disease, usually caused by high intraocular pressure, and is incurable. Therefore, glaucoma is far more dangerous than cataract.
During the formation and development of cataract, as the patient ages, the lens expands and increases in size, pushing the iris forward. In the eyes of some patients who originally had a shallow anterior chamber periphery, the iris root tends to come forward to block the anterior chamber angle, the structure in the eye where the atrial water flows out, resulting in blocked atrial water outflow, atrial water accumulation, and elevated intraocular pressure, i.e., acute attack of glaucoma. In another case, if a cataract patient fails to undergo surgery in a timely manner, the cloudy lens becomes “overripe”. The protein content of the clouded lens can leak out of the lens and cause an inflammatory reaction, which can also block the atrial outflow pathway and cause a glaucoma attack. Therefore, cataracts should be operated early when they affect vision to a certain extent.
The saying that “cataracts should be operated only when they are mature and invisible” is often spread among the elderly, but this was actually a concept 20 to 30 years ago because of the limitations of medical technology and surgery level at that time. At present, cataract ultrasound emulsification surgery is very mature and there is no need to wait until it is ripe before surgery. If this concept is not changed in time, patients will miss the best time for surgery, and cataracts will not only become overripe, but even cause acute glaucoma, leading to irreversible blindness.
Three types of cataract patients are prone to glaucoma 1. People with a family history of glaucoma, hyperopia, shallow anterior chamber, thin physique and short neck, whose vision in the morning is obviously better than that in the evening.
2, in the evening or dim light, easy to appear eye soreness, headache, rainbow vision (look at the light source with a halo or halo, in the evening look at the light bulb appears red and green circle), and even appear headache, nausea, vomiting and other performance.
3. Patients with long-term high blood pressure, diabetes, anxious or worried temperament should go to the hospital for an early examination and ask the ophthalmologist to help determine if there is a risk of glaucoma attack.
If the glaucoma is caused by cataract expansion and overripening, also known as crystal-derived glaucoma, the patient’s disease is not very long and the damage to the visual field and optic nerve is not serious, early cataract surgery can solve both problems of cataract and glaucoma. If the disease develops further and there are atrial angle adhesions, a certain degree of atrial angle separation on top of cataract surgery can also solve the problem. However, if cataract and glaucoma have occurred for too long, resulting in irreversible atrial angle adhesions and inability to drain atrial fluid, as well as severe crystal clouding that has seriously affected vision, combined surgery for glaucoma and cataract is required to control intraocular pressure. All these require patients to go to the hospital for detailed eye examinations, and the doctor will make a comprehensive judgment with the medical history.