The world's first irreversible blinding eye disease is particularly common in these groups of people

Glaucoma is called the "silent thief of vision" because its early symptoms are not obvious and it often "steals" people's vision without them noticing. Glaucoma ranks first among irreversible blinding eye diseases in the world, bringing a heavy burden to individuals, families and society.

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In order to raise public awareness and understanding of glaucoma, March 6th of each year is designated as World Glaucoma Day. Therefore, it is necessary for us to understand some basic knowledge about glaucoma, so as to achieve early detection, early diagnosis and early treatment of glaucoma, so as to better protect our eyesight.

What is glaucoma?

Glaucoma is a group of diseases with characteristic optic atrophy and visual field loss as common features. Pathological increase in intraocular pressure is its main risk factor. Normal human intraocular pressure usually ranges from 10mmHg to 21mmHg. Under normal circumstances, the intraocular pressure of both eyes should be consistent, and the difference should not exceed 4 to 5 mmHg.

In addition, intraocular pressure may fluctuate during the day, but usually this fluctuation does not exceed 8 mmHg. When the intraocular pressure of both eyes exceeds the above normal range, the risk of glaucoma should be considered (different measurement methods may vary and need to be combined with clinical evaluation).

In addition, there are some glaucoma patients whose intraocular pressure is within the normal range, which is called "normal-tension glaucoma". For these patients, early detection and early diagnosis are more difficult.

Which groups of people are more likely to develop glaucoma?

Some people may still have misunderstandings about glaucoma, thinking that it is a disease that only the elderly will get. This view is not correct. Glaucoma can occur at any age, and the following factors are recognized as risk factors for glaucoma. We should understand them and pay attention to them according to our own situation.

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Age: People over 40 have an increased risk of the disease, especially those with short axial lengths and hyperopia, who have an extremely high risk of the disease.

Family history: People with a family history of glaucoma have a 4 to 9 times higher risk than the general population.

High myopia: Patients with high myopia experience changes in the structure of their eyeballs and are more susceptible to glaucoma.

Long-term use of hormones: Long-term local or systemic use of hormones can lead to increased intraocular pressure and induce glaucoma.

Others: Patients with systemic diseases such as diabetes, hypertension, cardiovascular disease, and those with bad habits such as long-term smoking and alcoholism are also more likely to suffer from glaucoma.

What are the symptoms of glaucoma?

The early symptoms of glaucoma are not obvious, and the symptoms vary from patient to patient due to the type of glaucoma and the stage of disease progression. The common symptoms of glaucoma are mainly the following:

Iris vision: When patients look at lights at night, they may see a rainbow-like halo around the lights.

Eye swelling and pain: Glaucoma patients may feel eye swelling and pain, especially at night or after using the eyes for a long time. When intraocular pressure rises sharply, this pain may be more severe and even accompanied by headaches.

Red eyes, photophobia, and tearing: During an acute attack of glaucoma, the eyes become red due to congestion. At the same time, the pupils become dilated and photophobia occurs due to increased intraocular pressure. Symptoms of tearing may also occur due to corneal edema and damage to the corneal epithelium caused by high intraocular pressure.

Nausea and vomiting: Some patients may experience nausea and vomiting, especially when intraocular pressure rises sharply. Some patients with acute glaucoma attacks even go to the wrong department because of gastrointestinal symptoms.

Decreased vision and visual field loss: Due to optic nerve atrophy and visual field loss caused by glaucoma, patients will experience decreased vision and a gradually narrowing visual field. This change usually occurs gradually and is not easy to detect. It may not be detected until the disease progresses to the middle or late stages.

Considering the seriousness of glaucoma, if we meet one or even several of the high-risk factors, we should pay more attention to eye health and regular check-ups. So, what should we do? Next, let's talk about the prevention and treatment of glaucoma.

Prevention and treatment of glaucoma

Considering the characteristics and pathogenesis of glaucoma, the prevention of glaucoma mainly requires attention to the following three aspects:

1. Regular eye examinations: People over 40 years old should undergo a comprehensive eye examination every year, including intraocular pressure measurement, fundus examination, etc. People at high risk, such as those with a family history of glaucoma and high myopia, should shorten the examination interval or have an examination earlier.

2. Control systemic diseases: Actively control systemic diseases such as diabetes and hypertension to reduce the risk of glaucoma.

3. Avoid hormone abuse: Local and systemic hormone drugs should be used reasonably under the guidance of a doctor to avoid long-term use or abuse.

Treatments for glaucoma include medication, laser therapy, and surgery; doctors usually choose different treatments or combined treatments based on the type and severity of the patient's glaucoma. In addition, we should also pay attention to daily eye care, avoid long-term close-range use of the eyes, pay attention to eye hygiene, get enough sleep, quit smoking and limit alcohol, keep a good mood, and do appropriate physical exercise.

Conclusion

The early symptoms of glaucoma are not obvious and are easily ignored. Once symptoms such as decreased vision and visual field loss appear, it has often developed to the middle or late stage and the best time for treatment has been missed. Therefore, we must remember that early detection, early diagnosis, and early treatment are the key to controlling the progression of glaucoma and protecting vision. Although glaucoma has serious consequences, it is not uncontrollable. As long as we are vigilant and take active precautions, we can effectively reduce the risk of glaucoma occurrence and development and prevent it from taking away our sight.

Planning and production

Author: Jia Changkai Xiamen University Affiliated Xiamen Eye Center

Review丨Jin Xiuming, Deputy Director of the Ophthalmology Center, Zhejiang University Second Hospital