Increased intraocular pressure is one of the main risk factors for glaucoma. In daily life, try to avoid behaviors that can easily induce elevated intraocular pressure, such as overeating, smoking and alcoholism, overwork, long-term lack of sleep, long-term eye use in low-light environments, constipation, etc. In addition, at the same time, we must also insist on physical exercise, maintain a happy mood, avoid excessive mood swings, eat more diuretic foods, and maintain stable intraocular pressure. For high-risk groups such as high myopia, high intraocular pressure, family history of glaucoma, patients with cardiovascular and cerebrovascular diseases, diabetic patients, and the elderly, self-examinations can be performed frequently. When there is hard eyeballs and rainbow circles in the light, cause Note, check the intraocular pressure regularly and pay attention to your own vision.
Skin medicine hurts the eyes! Many people use steroid-containing drugs because of skin problems, but whether it is oral, topical, or injectable drugs, it may cause glaucoma. Excessive steroids can reduce the discharge of aqueous humor, increase intraocular pressure, and damage the optic nerve. Unexplained powders, black pills, even incense ash, Shenshui, etc., all need to be vigilant, so in the past experience, similar supplements or patent medicines have been tested to contain steroids. Be cautious to use eye drops containing corticosteroids. Long-term use of this kind of medicine may cause glaucoma, and it is not easy to detect in time. The visual damage caused by the discovery is often irreversible. So how do you tell if your intraocular pressure is too high and you need to go to the hospital for examination? As long as you look at the lamp tube with a rainbow halo, it means that the eye pressure may be too high; the so-called “rainbow halo” is because the eye pressure is too high and the eyes are relatively moist. When the light is refracted, the vision of the eye will appear rainbow. It’s like a rainbow after the rain.
Glaucoma is an irreversible blindness eye disease that requires early detection, early treatment, and control of intraocular pressure. For the surgical treatment of glaucoma, it is generally necessary to make artificial aqueous humor drainage channels to drain the excess fluid inside the eyeball to the outside of the eye to reduce intraocular pressure, so as to prevent the development of glaucoma and prevent further atrophy of the optic nerve. At present, the commonly used surgical methods include compound trabeculectomy, glaucoma drainage valve implantation, etc. The operation will be performed under local anesthesia of the eye. There is no pain during the operation. After the effect of the postoperative anesthetic is lost, the eye usually There will only be a mild foreign body sensation, but no obvious pain. Don’t worry about this. If a glaucoma patient has slight eye pain after surgery, antibiotic ointment can be applied to the eye to reduce the friction of the eyelid on the surgical incision site, thereby alleviating the symptoms of eye pain. Within one week after the operation of glaucoma patients, strict attention should be paid to maintaining eye hygiene. Dirty water and dust should not be allowed to enter the eyes, so as to prevent bacteria in the external environment from entering the eyeball through the surgical incision and causing infection, which is endophthalmitis. At the same time, pay attention to avoid touching or squeezing the eyes, especially not rubbing the eyes, otherwise it may cause the surgical incision to split, resulting in aqueous humor leakage, low intraocular pressure, shallow anterior chamber, choroidal detachment and other postoperative complications disease.
Glaucoma is an eye disease whose main symptoms are the continuous increase in intraocular pressure. Increased intraocular pressure will damage various parts of the eyeball to varying degrees. Because the symptoms and mechanism of the disease are not very clear, this also delays the condition of more patients and delays the best treatment opportunity, resulting in the development of glaucoma in the metropolis and a lifelong disease. Among the many types of glaucoma, the symptoms of “open-angle glaucoma” are even more insidious, and patients will only feel a little discomfort or headache and other symptoms, but no obvious symptoms. But at this time, the damage to the nerves has been going on quietly. Once discovered, the best time for treatment has already been missed. Once diagnosed with glaucoma, medication is first required. The usual practice is to instill eye drops to ensure the stability of intraocular pressure so that the visual field will not be further damaged. The intraocular pressure of ordinary people is 10-21mmHg, and the intraocular pressure of patients with glaucoma is an eye disease characterized by continuous increase in intraocular pressure. Therefore, controlling intraocular pressure is a must for glaucoma patients. Because glaucoma is a chronic eye disease, long-term medication is required. The medication is only used when the intraocular pressure rises, the medication is stopped if it is not high, and the medication is stopped if the intraocular pressure is not controlled. If you continue to drop the eye drops, the intraocular pressure will drop, but the patient may not feel it sometimes. Only by going to the hospital to check the intraocular pressure regularly can the intraocular pressure after the eye drops be detected. Patients with glaucoma should attach great importance to intraocular pressure and control intraocular pressure within a normal range. For patients with high intraocular pressure, it is necessary to observe changes in intraocular pressure, fundus and visual field for a long time. The intraocular pressure of patients with high intraocular pressure will continue to rise, once it exceeds the individual’s tolerance, glaucoma will cause optic nerve damage. High or low intraocular pressure does not necessarily mean glaucoma, but attention should be paid to it and long-term observation is necessary. Routine physical examination once a year is very necessary. Improving the level of understanding of the disease, adjusting the correct lifestyle, and checking the intraocular pressure and visual field regularly are the primary treatment methods for glaucoma patients to control the disease.
The boy, now 4 years and two months old, went to check his eyes on May 3. He had a high myopia without mydriatic computer refraction, both eyes were 200, the naked vision was 0.2+2 and 0.2, and the axis of the eyes was 23.69 and 23.49. The doctor recommended atropine infusion, which was started that night. On August 9th, the undilated vision improved to 0.4+ for both eyes, the axial length decreased to 23.53 and 23.34, and the non-mydriatic refraction also decreased to 150 and 125, respectively. But the measured intraocular pressure is high, 24. Could this be caused by tension? Because of the jet type, the movement is very loud, the baby will jump when the machine sounds, and will also close its eyes unconsciously. The doctor said that the child might be nervous and prescribed atropine eye ointment. He asked to start dripping on Wednesday night for three days and recheck the refractive index and intraocular pressure on Saturday. Excuse me: Is the high intraocular pressure caused by atropine? Can I continue to instill atropine in the future? Answer: Hello! Atropine is unlikely to cause high intraocular pressure in children. It is usually caused by tight eyes closed and the measurement is wrong. Usually it is normal after the retest, or the doctor can review the test. The follow-up medication should be judged based on the results of the examination. If necessary, it is clear that there is no problem with intraocular pressure and you can consider continuing to use it. (This is a case consultation received on the Public Welfare Day. I have hidden the brand of medical institutions and products, but I also hope that this case can help you.)
“Parents ask: After the child wears the orthokeratology lens, he finds that the intraocular pressure in both eyes has dropped to 8/9mmHg. I heard that the intraocular pressure is too low and it is not good. 9mmHg is already lower than the normal value. Will there be complications?” Pressure is a routine inspection item in ophthalmology. In the prevention and control of children’s myopia, such as wearing orthokeratology and using low-concentration atropine eye drops, routine and regular inspections are required. Including the “Guidelines for the Prevention and Control of Myopia” issued by the National Health Commission, it is also proposed to include the intraocular pressure examination of adolescents as a mandatory inspection item for the prevention and control of myopia in my country.  . Nowadays, the most commonly used examination equipment in outpatient clinics is non-contact intraocular pressure (NCT) measurement. The principle of this measuring device is to “blow” out a certain amount of airflow, and the pressure of the airflow on the central area of the cornea makes the central area of the cornea flat. The intraocular pressure is measured by the amount of “blowing” air flow. The higher the intraocular pressure, the larger the “blowing” airflow is needed to flatten the cornea (Figure 1).  .Figure 1 Principle of NCT to measure intraocular pressure . But if you use this “air jet” non-contact intraocular pressure measurement after orthokeratology, there will be problems. After orthokeratology, the curvature of the central cornea is flattened, and the higher the myopia degree, the more obvious the flattening of the curvature of the cornea after shaping. For example, after 500-degree myopia wears a shaping lens, the curvature of the central cornea changes from 43.00D before shaping to 38.00D. Then when using NCT to measure intraocular pressure, because the curvature of the cornea is relatively flat, a small amount of airflow from the device can reach the “flat” standard for IOP measurement (Figure 2). Therefore, because of the “blown” airflow If less, the device will recognize that the intraocular pressure is relatively low.  .Figure 2 The flattening of the corneal curvature is obvious after shaping, and the device will recognize that the intraocular pressure is relatively low. Therefore, for people with high myopia or relatively flat corneal curvature, it is easy to use non-contact intraocular pressure after orthokeratology. The condition where the measurement result is low is also called “false intraocular pressure drop”. The treatment method is also very simple, just change a kind of intraocular pressure measurement equipment. It is recommended to use a rebound tonometer (I-care tonometer, Figure 3). This tonometer will not “jet”. It measures the degree of speed reduction when the needle probe ejects to the cornea when the probe rebounds. To calculate intraocular pressure. Children, especially young children, have greatly improved coordination, and can rule out “false low intraocular pressure” caused by flattened corneal curvature after shaping. For details, see the previous article: “What should I do if the child does not cooperate with the “jet” intraocular pressure check?” .The children with reduced intraocular pressure mentioned at the beginning, we measured with a rebound tonometer, the intraocular pressure returned to normal. Same as before corneal reshaping. Figure 3 .I-care tonometer . Summary After the cornea is reshaped, the curvature of the cornea becomes flat, which will affect the accuracy of non-contact intraocular pressure measurement and easily cause “false intraocular pressure reduction.” The higher the myopia, the more obvious this situation. It is recommended to use a rebound tonometer (icare) to measure the intraocular pressure of those who have undergone corneal shaping, especially those with high myopia shaping.
The relationship between glaucoma and vision When it comes to glaucoma, one must first know what is glaucoma? What is intraocular pressure? The pressure exerted by the contents of the eyeball on the wall of the eyeball is the intraocular pressure. Generally, the normal value is: 10-21mmHg. Most patients are diagnosed with somatosensory symptoms such as eye swelling, eye pain, headache, blurred vision, etc., after detailed eye examinations (such as vision, intraocular pressure, visual field, UBM, fundus image, etc.) For glaucoma. The characteristic damage of glaucoma is the depressed atrophy of the optic papilla and the reduction of the characteristic defect of the visual field. Although the intraocular pressure of some patients exceeds 21mmHg, if it does not cause damage to the optic nerve and visual field, it cannot be called glaucoma. Everyone’s ability to tolerate intraocular pressure is different. There is a small part of patients whose intraocular pressure does not exceed 21mmHg, but their ability to tolerate intraocular pressure is poor, which can also cause damage to the optic nerve and visual field. It is called normal tension glaucoma. Early glaucoma may have no effect on vision, or may only manifest as visual field defects. In the later stage, some patients may have visual acuity of 1.0, but the visual field is getting smaller and smaller, and looking at things as if looking through a tube. Some people can’t even take care of themselves anymore, so they can’t assume that they won’t get glaucoma just because they have good eyesight. What kind of people are prone to glaucoma? For example, a family history of glaucoma, hyperopia, nearsightedness, a history of ocular trauma, diabetes, etc. If you have eye pain, blurred vision, and the scope of seeing things becomes smaller, you need to replace your reading glasses frequently, you should go to the ophthalmology department for timely treatment. Rule out the problem of glaucoma. Since the occurrence of glaucoma is related to age, the older the age, the higher the prevalence of glaucoma, so people over 40 should go to the hospital for regular check-ups.
. . . . . This situation mainly depends on who induced who. From the perspective of primary and secondary, first solve the main problem. For Asians, it is mostly cataracts, which means that the thickening of the crystals causes the onset of glaucoma. If this is the reason, surgery will first cure the cataract, and after the space is freed, the angle of the room will be widened and the aqueous humor will be able to circulate, and the problem of glaucoma will be solved.  . However, the clinical condition of patients is often not as simple as imagined, so treatment also depends on the specific situation. If the cataract induces an acute attack of glaucoma, only one or two attacks, and the attack time is not long, only need to use one or two ocular hypotensive drugs, you can control the intraocular pressure in the normal range; if the patient’s visual function, Even if the visual field and optic nerve damage are not serious, and the course of the disease is not very long, simple cataract extraction and intraocular lens implantation can control the intraocular pressure.  . . If the condition further develops, there is corner adhesion, just like the river is blocked for too long, the silt forms a dam, and a certain degree of corner separation based on cataract surgery can solve the problem. As long as the corner is open enough to maintain a normal life. Of course, there are still some patients who can’t solve the problem of intraocular pressure simply by performing cataract surgery. The coexistence of glaucoma and cataract is too long, resulting in irreversible adhesion of the angle of the chamber, and the aqueous humor cannot be discharged. The vision has been seriously affected, so glaucoma and cataract combined surgery, which is commonly referred to as white-gray combined surgery by doctors. These all need to go to the hospital for examination, and the doctor makes a comprehensive judgment based on the medical history.
Mr. Zhao, 77, has been fighting with glaucoma for more than seven years. In 2013, Mr. Zhao went to Guangzhou for medical treatment due to blurred vision in both eyes. He was diagnosed with “primary open-angle glaucoma” in both eyes. Due to the late discovery, the disease was serious and there was no obvious improvement in medical treatment. Since then, although he has gone through several hospitals, after several operations, he failed to prevent the deterioration of his eyesight. At the end of November last year, when Mr. Zhao came to our hospital, his right eye had lost his vision, and his left eye had only 0.2-0.4 vision. His visual function was severely damaged and he had a tubular vision. (Mr. Zhao’s left eye field of vision) & nbsp. (Mr. Zhao’s right eye field of vision) Dr. Shi Feng, who is good at the diagnosis and treatment of complex glaucoma, found that at that time, Mr. Zhao’s intraocular pressure was as high as 40.0mmHg, and the medical treatment could not control the intraocular pressure. If you do n’t go down, the remaining vision may not be guaranteed. ” Dr. Shi Feng urgently performed trabeculectomy for his left eye. “The patient’s right eye has been blinded, so the operation on the left eye is of great significance. At the same time, the risk to be taken is also higher! If the intraocular pressure is not effectively controlled after the operation, his vision may continue to decline or even become blind.” Fortunately, Mr. Zhao’s operation was very smooth, his postoperative recovery was good, his vision was stable at about 0.3-0.4, and IOP returned to normal. However, the visual damage caused by glaucoma has no possibility of recovery, and the patient is very satisfied with the current treatment effect. “At least I can live like a normal person.” Dr. Shi Feng: “After the operation, his intraocular pressure will still There are fluctuations, and the remaining sight is like a “candle in the wind.” The purpose of treatment now is to preserve the vision of his left eye and to ensure a normal life. “Just when everyone was relieved, in December, Mr. Zhao returned to the hospital again due to “fuzzy vision”. After examination, it was found that Mr. Zhao’s left eye had a new problem-macular edema, so the doctor gave him vitreous drug injection treatment + anterior chamber puncture + conjunctival suture. After many twists and turns, Mr. Zhao’s left eye finally stabilized slowly, and a long monitoring period began. We will ask patients to come back every 3 months, because glaucoma is a very painful disease. It is not like the treatment of cataracts and other eye diseases. It can be cured after surgery. Patients with glaucoma, like hypertension and diabetes, have no possibility of cure, but can only preserve and maintain their remaining vision. Therefore, the general treatment of glaucoma is lifelong and requires long-term cooperation between patients and doctors. Glaucoma is related to myopia, and it may also be a warm reminder that glaucoma is related to myopia, especially people with high myopia. The probability of developing glaucoma is much higher than that of ordinary people, and glaucoma also has a certain heredity, so a professional eye examination . In particular, because open-angle glaucoma is related to myopia, there is a tendency to become younger, and it is necessary to conduct targeted professional examinations from childhood. The most important thing in glaucoma treatment is: early detection and early treatment. At present, the methods of glaucoma treatment are relatively diverse, and the measures that can be taken include drug treatment, laser treatment, and surgical methods. Doctors need to follow up patients for a long time, adjust different treatment methods or carry out combined treatment according to different stages and symptoms.
The 15-year-old Meimei fell at school and injured her right eye. Her mother bought tobramycin and dexamethasone eye drops for treatment at the pharmacy. After 50 days of dripping, her right eye was almost fine The left eye, which was originally okay, became more and more blurred, and it was full of pain and headache, so I came to the hospital for treatment! & nbsp. The doctor found that Qian Qian ’s left eye’s intraocular pressure was twice as high as normal! Finally diagnosed as late glaucoma, almost blind. After asking the details, Qianqian is accustomed to drop normal left eyes together with eye drops. Hormonal eye drops can reduce inflammation, but can also increase intraocular pressure, and can cause glaucoma after long-term use. Even with the correct medication, hormone eye drops are usually used for no more than a month, otherwise there is a risk of glaucoma. & nbsp. In general, hormone eye drops are not recommended to be purchased by yourself. Before using, be sure to consult a doctor, ask the dosage and duration, and the doctor will check the safety. Hormone eye drops usually have the word “loose” in the name of the drug. Beware of incorrect use. Refer to the picture below
& nbsp. & nbsp. & nbsp. In the delivery room, every newborn baby will be “reviewed” by the people. When it comes to the standard of whether the newborn is beautiful or not, the most important thing is to see if there are a pair of black ones. Big eyes, if any newborn baby has big watery eyes, the pure and flawless eyes, let alone the child ’s parents, even us midwives ca n’t help complimenting and admiring. However, you can’t overdo it, and it is good for your baby’s eyes to be dark and bright. However, if you go beyond the routine, you will be in trouble. Know that one of the typical symptoms of congenital glaucoma is large eyes. Generally, the eyeballs of newborns are normal physiological phenomena, but if the size of the eyes of the two eyes is different, it will attract the attention of parents. If the baby’s eyes are much larger than those of the same age, it is best to go to the hospital to check the intraocular pressure to exclude the risk of congenital glaucoma. Because the baby’s scleral tension is weak, high intraocular pressure may cause the cornea to swell and thin. If the treatment is not timely, it may cause visual impairment or even blindness. & nbsp. & nbsp. & nbsp. & nbsp. When it comes to glaucoma, many people think it’s a matter for middle-aged and elderly people, how can they get a newborn baby? In fact, there is a kind of glaucoma, which is congenital. It is due to developmental disorders during the embryonic period, causing congenital abnormalities of the angular structure or residual embryonic tissue, blocking the aqueous humor discharge channel, resulting in increased intraocular pressure, and the entire eyeball is constantly increasing, also known as water The eye, or developmental phobia. In this disease, 1/3 occurs in the fetal period, with typical signs immediately after birth, and 2/3 appears after birth, the incidence rate is 1: 5000 ～ 10000; 60% ～ 70% is male; 64% ～ 85% For both eyes. & nbsp. & nbsp. & nbsp. & nbsp. Congenital glaucoma children have a certain name, called “bull eye”, which vividly describes the characteristics of congenital glaucoma babies, that is, the eyes are surprisingly large and growing. Other symptoms are fear of light, especially in strong light, the baby will not open his eyes and cry. There are also some babies whose eyes are always watery. The eyes are still enlarged. It may be one eye or two eyes at the same time. & nbsp. & nbsp. & nbsp. & nbsp. Because infants and young children cannot accurately express their feelings in words, many parents often find it difficult to find out that the baby has glaucoma in time. If the condition is delayed, the baby’s vision will be irreparably damaged. & nbsp. & nbsp. & nbsp. & nbsp. We had a child less than 6 months old in our hospital. When the baby was two months old, the parents found that the baby’s eyes were afraid of light and often wept. of. At that time, I didn’t care. I thought that the children’s eyes were like this, so they didn’t go to the hospital for treatment. Later, the baby’s photophobia symptoms worsened, and the black eyes in his eyes also increased significantly. Then he came to the hospital for examination. After visual inspection and eye After the pressure test, he was diagnosed with congenital glaucoma. Finally, after the surgical treatment, the baby’s intraocular pressure was normal and his condition was under control. & nbsp. & nbsp. & nbsp. & nbsp. Therefore, newborn parents should learn to carefully observe the daily behavior of their babies. If they have abnormal eyes, they must go to the hospital and ask a professional doctor for treatment. Glaucoma damage is irreversible, and only early diagnosis and treatment can better save vision and function, and minimize vision damage.