World Glaucoma Week丨Regular medication is important in treating glaucoma

March 12-18, 2023 is World Glaucoma Week. This year's theme is "Focus on Glaucoma: Consensus to Protect Vision, Guidelines to Protect Light". Globally, glaucoma is the leading irreversible blinding eye disease. At present, the optic nerve damage and visual field damage caused by glaucoma cannot be reversed. Therefore, glaucoma is called the "invisible killer" of human blindness.

Glaucoma is a blinding eye disease that seriously endangers health. At present, the treatment methods for glaucoma mainly include drug therapy, laser therapy and surgical treatment. Among them, drug therapy plays an important role in glaucoma, especially primary open-angle glaucoma. However, it is found in clinical practice that some glaucoma patients do not follow the doctor's advice to take medication and have adverse reactions. Now, combined with clinical cases, we will talk about the harm of glaucoma patients abusing eye drops and the importance of standardized medication.

First Story

Mr. Zhang has suffered from open-angle glaucoma for several years. He has been using timolol eye drops, one drop each time, once a day, and his intraocular pressure is well controlled.

Recently, Mr. Zhang had a conflict with his wife and was in a bad mood. He felt that his intraocular pressure was higher than usual, so he increased the frequency of use of timolol eye drops on his own, sometimes up to 10 times a day.

Mr. Zhang thought that by "increasing the dosage on his own" his intraocular pressure could return to normal. Unexpectedly, not only did his original symptoms not ease, but he also developed symptoms such as dizziness, fatigue, chest tightness, and discomfort in the precordial area.

Case Study

Timothy eye drops are currently the first-line drug for the treatment of glaucoma and are widely used clinically. It should be noted that the intraocular pressure-lowering effect of timolol eye drops lasts for a long time, and its antihypertensive effect can be maintained for 24 hours after a single dose. Increasing the number of uses per day does not increase the intraocular pressure-lowering effect, but will increase side effects. Glaucoma patients must take medication as directed by their doctor. Generally speaking, timolol eye drops can be used once a day, at most once in the morning and once in the evening. Excessive use of the drug can easily cause patients to experience symptoms such as bradycardia, arrhythmia, syncope, and may even cause serious consequences.

When using timolol eye drops, patients should also pay attention to their pulse. When the pulse is less than 55 beats per minute, use with caution. If symptoms of heart dysfunction occur, the drug should be discontinued immediately. Patients with toxic thyroid disease and diabetes should use the drug with caution. If the intraocular pressure of glaucoma patients cannot be controlled after taking the drug, other drugs should be used in combination under the guidance of a doctor, or surgical treatment should be performed.

Second story

Mr. Fu has been suffering from glaucoma for more than a year. In addition to using eye drops to lower intraocular pressure, he has been taking acetazobactam orally, and his intraocular pressure is under control satisfactorily.

Half a month ago, Lao Fu felt soreness and swelling in his eyeballs and increased intraocular pressure, so he increased the dose of acetazolamide on his own. However, the soreness and swelling in his eyeballs did not significantly reduce, and he felt numbness in his limbs, nausea, and loss of appetite. Lao Fu was hospitalized for renal colic and was diagnosed with kidney stones after examination. Combined with the medical history, the doctor believed that Lao Fu's condition was related to not taking acetazolamide correctly.

Case Study

Acetazolamide is a carbonic anhydrase inhibitor, which is currently widely used in the treatment of various types of glaucoma. Acetazolamide reduces intraocular pressure by inhibiting the secretion of aqueous humor and reducing the production of aqueous humor. It is important to take acetazolamide as prescribed by your doctor. The correct usage is: take 0.125-0.25 grams orally, twice a day, and the first dose can be doubled. Some patients think that taking a few more tablets of acetazolamide can increase the efficacy. In fact, doing so may not increase the efficacy, but may cause adverse reactions.

If acetazolamide alone does not produce satisfactory results, it can be used in combination with other ocular hypotensive drugs. Patients who take acetazolamide for more than 2 weeks also need to supplement potassium salts, take baking soda tablets orally to alkalinize urine, and have blood drawn regularly for routine blood tests and liver and kidney function tests. If serious adverse reactions occur, the drug should be discontinued immediately.

It should be noted that acetazolamide should not be taken for a long time. In clinical practice, patients are sometimes seen taking this drug for several months or even more than a year, which is very dangerous.

Glaucoma is a complex disease

Drug treatment needs to be carried out under the guidance of an experienced ophthalmologist

Generally speaking

Just follow the doctor's instructions and take the medicine correctly

Go to the hospital for regular checkups

Most adverse drug reactions are avoidable