The blinding rate is extremely high!Beware of this “sight thief” and require early diagnosis and treatment

The blinding rate is extremely high!Beware of this “sight thief” and require early diagnosis and treatment

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March 10th to 16th is the 17th World Glaucoma Week. This year’s theme is: jointly manage chronic disease glaucoma and keep the light long-lasting. Glaucoma is the world’s first irreversible blinding eye disease. The incidence rate of glaucoma is only lower than that of cataract, but its harm is far greater than that of cataract. Because of its insidious nature, 80% of patients have no symptoms before the onset of the disease. Therefore, glaucoma is also called the “thief” of vision. But few people know that the occurrence of glaucoma is also related to emotional and personality factors.

Glaucoma is a disease characterized by optic nerve atrophy and visual field defects. Due to pathological increase in intraocular pressure, which exceeds the tolerance of the optic nerve, it causes optic nerve damage and visual field defects, resulting in decreased vision or even blindness.

Qiao Chunyan, Chief Physician of the First Glaucoma Department of Beijing Tongren Hospital: There is water in our eyes, and it flows away through the sewers in our eyes. Where is the sewer in our eyes? This is our cornea, which is actually the black kernel of our eye. Open it, and this is our iris, with the cornea in front. There is an angle here, which we call the angle. This is actually the sewer for the water in our eyes. If the angle of the chamber is closed, blocked, or completely blocked, it is called closed-angle glaucoma. If it is not blocked, it appears to be open on the surface, but the water flow cannot pass, which is called open-angle glaucoma. Regardless of whether the angle is open or closed, it will cause an increase in intraocular pressure. Increased intraocular pressure will lead to optic nerve atrophy and visual field defects.

The “White Paper on Comprehensive Prevention, Treatment and Management of Glaucoma” released in 2023 shows that the prevalence of glaucoma in China is related to age but is trending younger. Experts suggest that patients of any age may suffer from glaucoma, but it is also favored by people who are over 40 years old; those with a family history of glaucoma; long-term use of hormonal eye drops; patients with high hyperopia and high myopia, etc. In addition, experts suggest that glaucoma is also related to emotions.

Wang Tao, director of the glaucoma department of Beijing Tongren Hospital: Being anxious and angry is essentially what will happen after being excited? There is a structure inside the eyeball, which we call the choroid or uvea. It will become congested and its volume will increase. Once it increases, it will cause an anterior chamber structure in the eye, and the angle of the chamber will become narrower from the original wider state. This is one of its essences. Therefore, we call the personality characteristics just mentioned glaucomatous personality, which are often a particularly important predisposing factor in inducing acute angle-closure glaucoma attacks.

The incidence of glaucoma is relatively hidden, and high-risk groups need regular check-ups.

According to the Blue Book on Comprehensive Prevention and Management of Glaucoma, a large number of patients have insufficient awareness of glaucoma disease and low social awareness. Two-thirds of glaucoma patients have developed to the mid-to-late stage when first diagnosed. So, how to improve glaucoma prevention and control awareness in daily life?

First of all, everyone must understand that the onset of glaucoma is relatively insidious. However, during an acute attack, intraocular pressure may rise sharply, and patients may present with symptoms such as eye pain, eye swelling, redness, decreased vision, headache, nausea and vomiting, and rainbow vision. However, these symptoms are often misdiagnosed as other diseases, thus delaying the best treatment time.

Wang Tao, director of the glaucoma department of Beijing Tongren Hospital: Many patients think that they have an attack of high blood pressure or that they have acute gastroenteritis. Some patients think that these symptoms are caused by another problem in their brain, such as cerebral hemorrhage. Due to these tendencies, many patients do not go to the ophthalmology department after getting sick, but go to the neurology department first to see if the intracranial pressure is high. So I think it is very meaningful for everyone to identify and prevent these diseases in the future.

Medical staff recommend that high-risk groups can undergo regular eye examinations, such as vision examinations, fundus examinations, and intraocular pressure examinations. Especially for people with a family history of glaucoma, it can often help patients detect abnormalities early.

The key to glaucoma treatment is to control intraocular pressure

Glaucoma threatens and damages the visual function of the optic nerve. This damage is irreversible at the current medical level, but this does not mean that glaucoma is untreatable. As long as it is discovered in time and treated actively, the condition can be effectively controlled.

Glaucoma can be treated clinically with drugs, laser and surgery. No matter what kind of treatment, the ultimate goal is to reduce intraocular pressure and prevent the disease from progressing.

Qiao Chunyan, Chief Physician of the First Glaucoma Department of Beijing Tongren Hospital: Intraocular pressure is the pressure inside our eyeballs. The normal value is 10 to 21 mmHg. If it is greater than 24 mmHg, it is considered pathological intraocular pressure. In general, the more severe the disease, the lower the target intraocular pressure should be, and the younger the patient is, the lower the target intraocular pressure should be. There are some related risk factors, including thin cornea, whether there is high myopia, and whether there are other diseases. As long as these risk factors are present, the target intraocular pressure and safe intraocular pressure should be lower.

Medical staff remind that glaucoma is a lifelong, long-term disease that requires constant maintenance. Therefore, patients with glaucoma should pay attention to regular follow-up visits to the hospital’s ophthalmology department. Some patients either think that they have no obvious symptoms and their vision is good, so they don’t care about it; or they think that they have glaucoma, which cannot be cured anyway and there is no need to treat it. Both attitudes are undesirable.

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