Glaucoma is one of the three major blindness-causing eye diseases that cause human blindness. The latest information shows that 20% of blindness in China is caused by glaucoma, which is the second most blinding eye disease after cataract. Glaucoma is an eye disease in which the pressure in the eye exceeds a certain limit, compressing the optic nerve and causing optic nerve atrophy and visual impairment. The optic nerve atrophy caused by glaucoma cannot be restored to function, so early detection and timely treatment are required.
The seriousness of glaucoma is obvious, but in life, we often see many patients come to the doctor when their glaucoma has developed to an advanced stage, or even when they have lost their eyesight, at which time the doctor can do nothing. Here I would like to answer some common misconceptions about glaucoma.
What are the early symptoms of glaucoma?
Glaucoma patients can have no symptoms in the early stage, some patients only feel visual fatigue and eye discomfort, some can show progressive myopia, blurred vision, some can have different degrees of eye distension, nasal root pain and headache or nausea, foggy vision and rainbow vision (see lights with rainbow-like halo) phenomenon, after rest, these symptoms can disappear, so patients are easy to ignore, so that the opportunity of early diagnosis and treatment is lost. These symptoms can disappear with rest, so patients can easily ignore them and lose the opportunity of early diagnosis and treatment. In the advanced stage, when the visual field (the area that the eyes can see) of both eyes is reduced, there may be night blindness and mobility problems. Some patients think it is gastroenteritis, high blood pressure or cold and take medication to treat the condition or make it worse by the opposite treatment, making it difficult to recover the vision.
What are the causes of glaucoma?
Glaucoma is roughly divided into three categories: congenital glaucoma, primary glaucoma, and secondary glaucoma. Congenital glaucoma mainly occurs in infants and children, some before birth, and is mostly caused by congenital developmental abnormalities. Primary glaucoma is for those whose cause is unknown. Secondary glaucoma is caused by other eye diseases or systemic diseases, etc. Common causes are fundus hemorrhagic diseases, trauma, and cataracts in the expansion phase.
It is worth noting that long-term application of hormonal eye drops or long-term use of hormones for kidney disease, lupus erythematosus, skin disease, etc. may lead to the occurrence of “hormonal glaucoma”, which is often not easily detected in time and is diagnosed as glaucoma only at an advanced stage. The damage to visual function caused by glaucoma is irreversible, and some patients are clinically blind due to hormone use, so it is recommended that such patients should insist on regular IOP reviews.
Who is prone to glaucoma?
The following groups of people should pay special attention: people with a family history of glaucoma; elderly people who were farsighted when they were young; young people with highly myopic eyes; people with a history of eye trauma, especially those who have had high intraocular pressure after the injury; people with a history of hypertension and diabetes; people with an impatient or worried temperament; patients who are found to have elevated intraocular pressure or an enlarged or asymmetrical cup/disc during physical examination; and patients with migraine headaches.
Is glaucoma not serious if the vision is good?
Patients with visual field defects caused by glaucoma in the early stages can feel nothing, and some people can also feel nothing when the IOP rises, and patients can still maintain good vision when the visual field is very small in the late stages of development.
Can glaucoma be prevented?
No, it cannot. Only early detection and early treatment are possible. It is recommended that people over 40 years of age, especially those with a family history of glaucoma, should have regular eye examinations, and should be reviewed regularly even if the examinations are normal. If obvious anatomical abnormalities (e.g. short eye axis, thick crystalline lens, shallow anterior chamber) or IOP abnormalities are found then further examinations such as 24-hour IOP check, provocation test, OCT, etc. are recommended.
How is glaucoma treated?
Treatment for glaucoma must be prescribed by your doctor. The treatment of glaucoma is complex due to the different types and clinical manifestations of glaucoma, as well as individual differences. It can be roughly divided into medication, laser treatment and surgery. Early glaucoma can be treated with pressure-lowering drugs (local drops or oral). If the IOP cannot be controlled by medication, surgery is necessary. The ophthalmology department of the City Hospital of Traditional Chinese Medicine currently has a variety of medications and surgical procedures to treat glaucoma, enabling early detection of glaucoma to achieve a good prognosis through regular treatment.
Glaucoma diagnosis and treatment is a continuous process, and each hospital has different instruments and equipment, different treatment routines, and each doctor is always more confident and familiar with the results of various tests and reports of the hospital, therefore, we advocate that patients should be treated at a fixed location as much as possible.
How to take care of glaucoma patients?
Glaucoma is a lifelong disease, so it is important to follow medical advice and have regular follow-up examinations. Self-care of patients is also important.
Mood swings and excessive fatigue can cause fluctuations in IOP, so it is important to be relaxed and combine work and rest.
2, the onset of closed-angle glaucoma is most often seen in the dusk, evening, gloomy weather and cold season, so patients with glaucoma should not read or work in dim light, avoid the dark environment (such as cinemas) for too long. Turn on the headlights in the house when watching TV or studying at night. Pay attention to keep warm when the weather changes.
3. Do not overeat in daily life, eat more vegetables and fruits, and keep your bowels open. Avoid drinking strong tea and coffee, and drink a small amount of alcohol. Do not drink too much water at a time, which can reduce the onset of glaucoma and help control glaucoma.
4. Patients with normal IOP after surgery should also insist on review to prevent recurrence and damage to visual function.
5. Patients with closed-angle glaucoma should use atropine and its derivatives such as scopolamine, gastric longing, gastric ling, gastric an, gastric cheer, gastric rehab, gastric ulcer and other drugs with caution.