Glaucoma is the second most common blindness in the world, with a rapid onset and high risk of irreversible blindness at any time, and the prevalence of primary glaucoma in China is 0.25% and the blindness rate is 10%. Early damage to glaucoma is firstly visual field and then vision, and once visual field damage and vision loss occur, both of them are irrecoverable. Therefore, glaucoma needs early diagnosis and treatment to maintain effective visual function.
I. Glaucoma classification
There are four main classifications of glaucoma: congenital glaucoma, primary glaucoma, secondary glaucoma, and mixed glaucoma.
Congenital: according to the age of onset, it can be divided into infantile glaucoma and juvenile glaucoma.
Primary: According to the morphology of the anterior chamber angle and the urgency of the onset, it can be divided into acute and chronic closed-angle glaucoma and open-angle glaucoma.
Secondary: The common types are inflammatory glaucoma, blunt contusion-related glaucoma, lens-related glaucoma, vascular disease-related glaucoma, and drug-related glaucoma.
Mixed type: two or more types of glaucoma are present at the same time.
Second, who are prone to glaucoma
1) People with a family history of glaucoma;
2) People with sore eyes, pain, iris, and blurred vision;
3) Patients with diabetes;
4) People with high myopia;
5) People with sudden increase in myopia or presbyopia;
6) People with cataracts causing significant vision loss;
7) People over 40 years of age who have not had an eye examination;
8) Those who have applied steroids locally or systemically;
9) Those who have had trauma to the front of the eye.
How to detect glaucoma early
Primary open-angle glaucoma and primary closed-angle glaucoma are easier to diagnose during an attack, but usually many people have no symptoms, so a detailed eye examination is important!
1. Visual field examination: Changes in the visual field are the most obvious feature of glaucoma, so a visual field examination can be effective for early screening of glaucoma. In glaucoma patients, progressive visual field defects can be seen, especially with the use of advanced automatic computer analysis of visual field examination, which can provide physicians with a very valuable basis for treatment.
2. Regular measurement of IOP: Above the age of forty, IOP should be measured once a year. If you have high myopia, hypertension, diabetes and a family history of glaucoma, you should measure IOP once a year and monitor the 24-hour IOP fluctuation curve if necessary.
3.Fundus nerve examination: The physician uses fundoscopy to observe the changes of the optic nerve in the fundus of the eye, whether there are changes of retinal blood vessels and optic nerve atrophy.
4.Ocular anterior chamber angle microscopy: anterior chamber angle microscopy and UBM to check the atrial angle.
5.Elicitation test: When the symptoms are uncertain, but there is no obvious change in the optic nerve, various evocation tests, such as dark room prone and dilated pupil test and drinking test, can be performed to establish the diagnosis.
6.Posterior segment OCT: detect the thickness of retinal nerve fiber layer and optic disc parameters.
IV. Common treatment methods
Glaucoma treatment methods include medication, laser treatment and surgery. Different types of glaucoma require different treatment methods. The purpose of drug control or surgical treatment is to reduce intraocular pressure and protect vision and visual field as much as possible.
V. Advantages of our department
The Second Department of Ophthalmology of the First Hospital of Jilin University provides strict screening for all kinds of glaucoma, including acute/chronic glaucoma, cataract combined with glaucoma, congenital glaucoma, secondary glaucoma such as ocular trauma and fundus hemorrhage, etc., with emphasis on early diagnosis and early treatment to save patients’ visual function in time. It not only avoids the pain of postoperative foreign body sensation and suture removal, reduces postoperative complications, shortens hospitalization days, but also reduces the economic burden of patients.
Prevention and health care
1. Keep a comfortable mood and avoid excessive emotional fluctuations.
2.The elderly, especially those with glaucoma quality, should be careful not to stay in the dark light for too long.
3.Use anticholinergic drugs, such as atropine, with caution.
4. Glaucoma should be reviewed regularly throughout the life from the time of diagnosis.
5.After the surgery, it is not “all right”, and regular check-ups are needed.