Gao Hui, Department of Ophthalmology, Characteristic Medical Center (formerly 306 Hospital).
Edited by Liu Yan/Cui Yan, Medical Science Popularization Center
Glaucoma is one of the three major blind eye diseases that cause blindness in humans, and the age of onset is more than 45 years old, which refers to a common and difficult eye disease with intermittent or continuous increase in intraocular pressure.
Persistently high intraocular pressure can cause damage to the tissues and visual function of various parts of the eyeball, resulting in optic nerve atrophy, visual field reduction, and vision loss. Some people can be completely blind in 24~48 hours during the acute attack, so it is necessary for everyone to master some knowledge about the prevention and treatment of glaucoma.
Predisposing factors for glaucoma
Anyone is at risk of developing glaucoma, but the following groups of people are at higher risk.
(1) Those with a family history of glaucoma. The prevalence of first-degree relatives (parents, children, and siblings) over the age of 40 years in patients with primary glaucoma is significantly higher than in the general population. According to statistics, the prevalence of first-degree relatives with primary open-angle glaucoma is 10 times higher than that of normal people. The prevalence of first-degree relatives of primary angle-closure glaucoma is 6~9 times that of normal people.
(2) Elderly. Older people are at greater risk of developing glaucoma and increase with age. After the age of 50, the lens gradually absorbs water and swells, the nucleus hardens, and the suspensory ligament relaxes, causing the anterior chamber to be shallow, the angle is narrow, and the circulation of aqueous humor is blocked, which in turn causes the intraocular pressure to rise.
(3) Refractive error. People with farsightedness, short eye axis, and small eyeballs are susceptible to angle-closure glaucoma, while people with high myopia are prone to open-angle glaucoma.
(4) Those with systemic diseases related to glaucoma. Patients with diabetes, hypertension, and hyperlipidemia are prone to retinopathy if they are not well controlled, and secondary neovascularization obstructs the angle, resulting in neovascular glaucoma.
(5) Those who use certain drugs. People who take topical or systemic glucocorticoids for a long time can develop hormone-induced glaucoma, which is related to the duration of the drug, the dose of the drug, and individual susceptibility.
Reminder: People with the above risk factors should have regular eye exams for early detection of glaucoma.
Symptoms that can occur with glaucoma
(1) Increased intraocular pressure. A rough sense of intraocular pressure can be applied to the fingers of the eyeball, which is elastic like the tip of the nose, and when the intraocular pressure rises, the eyeball will become hard when touched.
(2) Eye swelling and eye pain, or headache. In the early stages of acute angle-closure glaucoma, there is only mild eye soreness and headache. During the acute attack, the intraocular pressure rises sharply due to the closure of the angle, and there is significant eye tenderness accompanied by ipsilateral headache, but some open-angle glaucoma may not have any swelling pain and discomfort, and is only manifested by the patient's self-reported "visual fatigue".
(3) Blurred vision. Visual acuity decreases dramatically during the attack of angle-closure glaucoma, and although vision can be restored to a certain extent after remission, the damage to the eye cannot be completely reversed. Chronic angle-closure glaucoma and primary open-angle glaucoma have advanced central vision loss with characteristic visual field defects and reductions.
(4) Rainbow vision. Corneal edema caused by increased intraocular pressure causes light to diffract light, and a rainbow of orange on the outside, violet-blue on the inside, and green in the middle appears when looking at a fluorescent lamp.
(5) Nausea and vomiting. The increase in intraocular pressure during an acute attack of glaucoma can reflexively cause the vagus nerve and vomiting nerve centers to be excited, resulting in nausea and vomiting.
Reminder: There is also a special type of glaucoma - normal intraocular pressure glaucoma, which can only be detected by an ophthalmologist in the early stage, so it is important to have regular ophthalmic examinations.
Glaucoma prevention tips
(1) Maintain healthy eye habits: avoid overworking the eyes and do not use your eyes for a long time in dim light.
(2) Develop good living habits: pay attention to the combination of work and rest, maintain emotional stability, and maintain good sleep.
(3) Manage systemic diseases: control hypertension, diabetes and other diseases, and reduce the negative impact of these diseases on eye health.
(4) Avoid eye injuries: Wear protective glasses when participating in strenuous activities that may cause eye injuries.
Reminder: Prevention of glaucoma is more important than treatment, and regular eye examinations are the key to preventing glaucoma and protecting vision.
(The picture comes from the Internet)