Cataract and glaucoma are the first and second most common blind eye diseases in China, but cataract can be restored to sight after surgery, while glaucoma blindness is permanent and irreversible. Statistics show that the average time from onset to treatment of glaucoma patients in China is about 7 days, which is longer in remote rural areas. Primary glaucoma is often misdiagnosed because of other symptoms, such as migraine, nausea and vomiting. Sometimes, such misdiagnosis is is disastrous — for example, using atropine to relieve spasms due to nausea and vomiting can rapidly aggravate the progression of glaucoma and lead to blindness.
Glaucoma, commonly known as “blindness with open eyes”, is a disease of blindness caused by sudden narrowing or closure of the angle of the inner chamber of the eye, failure of timely discharge of aqueous humor, resulting in full aqueous humor and sharp increase in intraocular pressure. It is named after the pupil of the patient, which is often cyan. There are regional, ethnic, gender and age differences in its incidence, which is more common in Asia, especially in China; The number of yellow people is the most, the number of black people is the second, and the number of white people is the least; The ratio of male to female is 1:3; Most of them are over 40 years old, and most of them are between 50 and 70 years old.
In addition to the anatomical structure, the occurrence of glaucoma is also related to emotions. Women who are sentimental, grumpy and paranoid are more likely to suffer from glaucoma, also known as glaucoma.
Recently, we came across a case like this – – Aunt Zhang, 57, began to have right migraine 4 years ago. When she had the attack, she could feel the blood vessels jump suddenly and her eyes were also a little swollen and painful. Aunt Zhang was originally quick tempered and irritable. After she fell ill, her temper became worse. She often became angry over a small matter. Her family carefully tried to avoid provoking her.
About half a month ago, Aunt Zhang suffered from migraine again. This time, the pain was not only intense and lasting for a long time, but also there was obvious blurred vision. The treatment in the local township hospital did not produce any effect. With the advice of the doctor and the persuasion of her family, Aunt Zhang, who was in unbearable pain, went out to see a doctor for the first time. The examination found that Aunt Zhang’s right eye was as hard as stone, and the measured intraocular pressure was as high as 70mmhg (more than three times higher than normal). She was diagnosed as “primary angle closure glaucoma”, and she was given dehydration and decompression treatment immediately. Fortunately, after the intraocular pressure dropped to 30mmhg, it was found that the optic nerve had not been damaged by examination of the fundus.
Early detection of glaucoma can be treated by laser drilling, which has little trauma and good effect. However, if the optic nerve atrophy occurs, vision will be permanently lost. Therefore, improving the public’s awareness and vigilance against glaucoma is of great significance to prevent blindness. Acute angle closure glaucoma is ferocious. At the onset, the eyes are obviously congested, accompanied by severe eye swelling and headache, sharp vision loss, hard eyeballs, nausea and vomiting, elevated blood pressure, low fever and other symptoms. It is often misdiagnosed as gastroenteritis, encephalitis and nervous headache because of its severe systemic symptoms.
Acute angle closure glaucoma belongs to the emergency department of Ophthalmology, and proper treatment must be taken against time, otherwise complete blindness can occur within 24-48 hours. Glaucoma has a certain heredity. If there is a glaucoma patient in the family, other relatives over 40 years old should be highly vigilant against glaucoma when they have migraine, eye swelling and pain.
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