Glaucoma, the silent thief of vision

1. What is glaucoma?

Glaucoma is a group of common eye diseases that threaten the optic nerve and visual function. It refers to a pathological increase in intraocular pressure that exceeds the maximum limit that the intraocular tissue can tolerate, resulting in characteristic optic nerve atrophy, specific visual field defects, decreased vision and even blindness. It is the world's number one irreversible blinding eye disease.

The eye is a sphere, called the eyeball. The optic nerve is at the end of the eyeball, and the optic nerve is connected to the visual center of the brain like a cable. The eyeball is an elastic sphere filled with fluid. The fluid is secreted by the ciliary cells in the eyeball. The fluid supports and nourishes the eyeball, and then is discharged through the chamber angle of the elimination duct. The fluid in the eye is a dynamic balance. When the elimination duct is blocked or dysfunctional, the fluid in the eyeball cannot be discharged and accumulates in the eyeball. The intraocular pressure increases, compressing the optic nerve, exceeding the tolerance limit of the optic nerve, and the optic nerve partially dies, vision decreases, is severely damaged, and the visual range is reduced. If the optic nerve dies completely, the patient will become blind. Because glaucoma eventually damages the optic nerve, and the nerve death cannot regenerate, the vision loss and blindness caused by glaucoma are irreversible.

2. How many people in the world suffer from glaucoma?

There are 70 million glaucoma patients in the world, and about 60% of them are located in Asia; in my country, the prevalence of glaucoma is about 2%, and the blindness rate is 22.7%, accounting for 8.8% of the blind population; among people over 40 years old, about 9.2 million people suffer from glaucoma, of which 55% are blind in at least one eye and 18.1% are blind in both eyes.

3. Who is susceptible to glaucoma?

① The incidence of glaucoma in people over 60 years old is four to ten times higher than that in people in their 40s.

② Patients with a family history of glaucoma have a certain genetic tendency to glaucoma, and 10% to 15% of individuals may develop glaucoma.

③ The prevalence of glaucoma in patients with refractive error and myopia is twice that of emmetropia

④ Diabetic patients The risk of glaucoma in diabetic patients is 2.12 times that of non-diabetic patients.

4. What are the types of glaucoma?

Glaucoma is mainly divided into primary glaucoma, secondary glaucoma, and congenital glaucoma. Primary glaucoma is further divided into angle-closure glaucoma and open-angle glaucoma. According to the speed of onset, primary angle-closure glaucoma is further divided into acute and chronic types.

5. What are the dangers of glaucoma?

⑴ Glaucoma is a latent disease that is difficult to detect. 50% of glaucoma patients are already in the late stage when they seek medical treatment. Most early glaucoma patients do not have any symptoms and can maintain good vision, but their visual field is constantly shrinking. When blurred vision occurs, it is often the late stage of optic nerve damage, so it is called the "silent thief of vision."

⑵ More than 90% of patients do not understand glaucoma and have the misconception that glaucoma, like cataracts, can be cured and visual function restored, thus delaying treatment.

⑶ The impaired visual function of glaucoma patients also seriously affects the patients' quality of life, increases the patients' psychological burden, and causes them to experience symptoms of anxiety, nervousness, and stress.

6. How to treat glaucoma?

Once glaucoma is diagnosed, it should be treated immediately. Treatments for glaucoma include medication, laser, and surgery. The goal of treatment is to lower intraocular pressure, reduce intraocular pressure fluctuations, prevent further damage to the optic nerve, and protect visual function. For different types and stages of glaucoma, the treatment plan is different, and the doctor will propose a specific treatment plan based on the patient's specific situation.

7. How to prevent glaucoma?

The principles of glaucoma prevention and treatment are early detection, early treatment, controlling the disease, and avoiding or delaying optic nerve damage, among which early detection is the key.

Normal people over 40 years old should have an eye examination once a year, including intraocular pressure measurement and fundus examination; people at high risk of glaucoma, such as those with a family history of glaucoma, severe myopia, severe hyperopia, eye trauma or other eye diseases, those who use hormone eye drops for a long time, or those who need long-term systemic use of hormones, or those with diabetes, should be more vigilant and have regular examinations.

Our ophthalmology glaucoma team has unique insights into glaucoma screening, diagnosis, treatment, and follow-up. In terms of glaucoma diagnostic techniques and methods, we have more than 20 advanced diagnostic and treatment equipment, including OCT, automatic perimeter, multifocal VEP, fundus stereophotography, panoramic ultrasound biomicroscope (UBM), rebound tonometer, ultrasonic corneal thickness meter, YAG laser machine, etc. The advanced level of the equipment and the team's diagnostic and treatment capabilities have reached the same level as first-class hospitals in China. The establishment of a 24-hour intraocular pressure monitoring room can make a more accurate and comprehensive evaluation of intraocular pressure changes in glaucoma patients. Skilled in carrying out various glaucoma laser surgeries (laser peripheral iridectomy, laser peripheral iridoplasia, laser pupil form) and microsurgeries (compound trabeculectomy, glaucoma drainage implantation, trabeculectomy combined surgery). In addition to surgery, it can also be combined with comprehensive treatments such as traditional Chinese medicine syndrome differentiation and acupuncture, combining traditional Chinese and Western medicine to bring light to more glaucoma patients.

Department of Ophthalmology, The Third Affiliated Hospital of Beijing University of Chinese Medicine

Author: Guo Lixia Reviewer: Wang Zhiqiang