Experts in this issue: Zhou Jian, chief physician of the Department of Ophthalmology, East Hospital, Beijing University of Chinese Medicine, and Zhu Jiamei, graduate student.
1. What is glaucoma?
Glaucoma is caused by excessive production of aqueous humor in the eye or obstruction of circulation, that is, the "water leakage" in the eye, which makes the intraocular pressure exceed the degree that the tissues in the eyeball, especially the retina and optic nerve can bear, and then cause irreversible vision loss and even blindness.
2. Who is susceptible to glaucoma?
The prevalence of glaucoma in China is high, and although most of the patients are elderly, glaucoma can occur in all ages. Patients with the following risk factors should go to the hospital for standardized glaucoma screening in time, and correct the bad lifestyle and eye habits in time, and accept preventive measures according to the doctor's instructions if necessary.
1. Intraocular pressure is high (the normal range of intraocular pressure is 10-21mmHg);
2. Those with a family history of glaucoma;
3. People with anatomical features such as shallow anterior chamber, short eye axis, thick lens, and short corneal diameter;
4. High myopia and farsightedness;
5. People with a history of ocular trauma and long-term use of hormones (especially local eye drops);
6. Patients with diabetes and cardiovascular diseases;
years of age. 3. What are the common symptoms of glaucoma?
Different types of glaucoma have different clinical presentations. Among them, acute angle-closure glaucoma is one of the ophthalmic emergencies, and patients present with eye pain, sharp loss of vision, severe head pain on the same side, red eyes, accompanied by nausea and vomiting. Patients with chronic angle-closure glaucoma and primary open-angle glaucoma often have no obvious sensation or only eye soreness or swelling pain, fatigue, and blurred vision, which are relieved after rest. For people who have high-risk factors for glaucoma, or who have never undergone an eye examination, they should seek medical attention if they have corresponding symptoms.
4. Is high intraocular pressure glaucoma?
This is not the case. Elevated intraocular pressure is the main clinical manifestation of glaucoma, but it is not the only criterion for diagnosing glaucoma. Clinically, some people have higher intraocular pressure than normal, but no optic nerve damage and visual field defect are seen, which is called ocular hypertension. However, some patients have developed optic nerve damage and visual field defects, but the intraocular pressure is always within the normal range, which is called normal intraocular pressure glaucoma. Therefore, the exclusion of glaucoma is not only based on intraocular pressure, but also on the comprehensive evaluation of the angle, optic disc, optic nerve, etc.
5. Why is my eyesight so good that I am also diagnosed with glaucoma?
Because the visual field defects caused by glaucoma are progressive, vision is not affected in the early stages. However, when visual acuity loss or centripetal visual field narrowing is evident, it is often in the middle and advanced stages, and the disease process cannot be reversed by either**. If left unchecked because of the perceived lack of obvious discomfort, the disease will eventually "steal" the light without realizing it.
6. Can glaucoma be **?
Secondary glaucoma caused by factors such as trauma or hormones is mostly no longer caused by removal. Primary glaucoma, on the other hand, is lifelong. However, glaucoma can be prevented and controlled, as long as it is diagnosed early and standardized**, it can still maintain a certain visual function as much as possible during the survival time, and have a good quality of life.
Glaucoma includes medications, lasers, and surgeries. It can also improve systemic symptoms, stabilize and reduce intraocular pressure, and improve the thickness of the optic nerve fiber layer through oral Chinese medicine. TCM acupuncture can be performed in patients with well-controlled intraocular pressure but persistent optic nerve damage, or with headache and eye tenderness**.
7. Can glaucoma patients stop taking the drug after the intraocular pressure is normal?
First of all, the normal intraocular pressure is not equal to the safe intraocular pressure or the target intraocular pressure of the patient with Qingguan eye, and the intraocular pressure control goal needs to be personalized by the doctor according to the patient's condition during the follow-up. Secondly, lowering blood pressure after medication is the effect of the drug, and the intraocular pressure will increase again after stopping the drug, and the high and low intraocular pressure is more harmful to the optic nerve, so it is never advisable for the patient to stop the drug on his own, and the medication should be maintained according to the doctor's instructions.
8. What are the precautions for glaucoma?
In addition to standardized** and close follow-up, glaucoma patients should also carry out self-lifestyle management. Eat lightly, quit smoking and drinking, ensure sufficient sleep time, avoid acute intraocular pressure increase caused by dilated pupils in a dark environment for a long time, do not drink excessive water at one time when thirsty, keep a good mood, and avoid the impact of anxiety, excitement, irritability and other bad emotions on the disease. In addition, there are some simple ways to self-check:
1.Cover one eye alternately and check for abnormalities in the clarity and range of vision in the other eye
2.Close your eyes and use your index finger to alternately press on your eyeball to feel the firmness of your eyeball: if it is as soft as your lips, your intraocular pressure may be low;If it is as hard as the tip of the nose, the intraocular pressure may be normal;If it is as hard as the forehead, the intraocular pressure is likely to be elevated.
However, these self-test methods can only be roughly judged, and if the eyes are uncomfortable, you need to seek medical attention as soon as possible for further treatment.