Original title: Ophthalmologists call for vigilance against the eye disease that quietly “steals” vision — glaucoma
Glaucoma is an irreversible blinding eye disease. Due to intermittent or continuous increase in intraocular pressure, insufficient blood supply to the optic nerve in patients with glaucoma, followed by gradual atrophy of the optic nerve and gradual apoptosis of nerve cells, resulting in irreversible damage such as vision loss, visual field defect and even permanent blindness.
“Under the current medical technology, nerve damage cannot be regenerated. Therefore, the visual function and visual field defects caused by nerve damage already caused by glaucoma are irreversible.” March 6-12 this year Today is the 15th “World Glaucoma Week”. Professor Zhu Siquan, director of the Eye Center of Beijing Anzhen Hospital Affiliated to Capital Medical University, reminded everyone to pay attention to glaucoma, an eye disease with high incidence and quietly “stealing” vision in my country.
Glaucoma damage is irreversible and early screening is the key
At present, glaucoma is mainly divided into primary glaucoma, secondary glaucoma, and childhood glaucoma. In the early stage of glaucoma, there are often no obvious symptoms, while vision and visual field are unknowingly “stolen”. When glaucoma suddenly “explodes” or progresses quietly, there may be red eye pain, decreased vision, eye swelling, headache, nausea and vomiting, visual “rainbow circle”, and reduced visual field.
Zhu Siquan said that due to the irreversibility of glaucoma damage, early screening is the key to preventing problems before they occur. Healthy people should maintain systematic eye examinations every year. For people with high risk factors and diagnosed glaucoma patients, the frequency of examinations should be appropriately increased to avoid the occurrence and development of the disease.
At the same time, Zhu Siquan suggested that for people over 40 years old, a more comprehensive eye health examination is required, especially as the lens ages, expands and squeezes the angle of the chamber with age. Atrial depth, angle shape, lens thickness, fundus and visual field were examined. In addition, presbyopia and cataracts are also “warning signs” that cannot be ignored. Early treatment of cataract extraction combined with intraocular lens implantation can solve the problem of excessive expansion of the lens, thereby avoiding the occurrence of glaucoma. For high-risk groups with family history of glaucoma, high myopia or hyperopia, too long or too short axial axis, and abnormal blood pressure and blood sugar, it is even more necessary to screen early and appropriately shorten the screening cycle.
Artificial intelligence technology helps early glaucoma screening
It is reported that the fundus and visual field examinations of early glaucoma have no obvious changes, and many examinations rely on doctors Empirically, early atypical changes may be missed clinically. Zhu Siquan said that with the progress and development of my country’s science and technology, the emergence of artificial intelligence technology (AI) is gradually solving this problem. Artificial intelligence technology establishes an algorithm model for glaucoma screening through deep learning. By extracting the patient’s eye parameters, the AI algorithm uses its own calculation of the optic cup and optic disc contour and ratio, the disc edge width parameter, the optic nerve fiber layer defect and other parameters, and comprehensively evaluates to determine whether the patient has the risk of glaucoma optic nerve damage.
“Currently, the screening of AI technology is mainly based on fundus photos. In the future, comprehensive judgment of eye conditions such as the anterior segment of the eye and visual field examination will bring good news to the early screening of glaucoma. At the same time, Using high-quality AI algorithms and the continuous maturity of 5G technology, the implementation of comprehensive eye disease screening including glaucoma based on remote reading and consultation on the Internet will be a relatively economical new screening model in the future.” Zhu Siquan said.
Adherence to treatment and regular follow-up is the top priority to prevent visual impairment
How to treat glaucoma?
Zhu Siquan introduced that the visual function and visual field defects caused by nerve damage already caused by glaucoma cannot be cured. The goal of treatment is to stop the progression of glaucoma as much as possible, reduce the loss of retinal ganglion cells, and maintain visual function. In terms of treatment, drugs, lasers, surgery, etc. are mainly used for treatment. At the same time, the monitoring of intraocular pressure and nerve function is required, and the treatment plan is adjusted regularly.
Meanwhile, Zhu Siquan pointed out that glaucoma, like hypertension and diabetes, is a disease that requires lifelong treatment and follow-up. Regardless of the type of glaucoma, treatment is a slow, long-term process. After treatment, it is necessary not only to monitor the intraocular pressure regularly, but also to check the optic nerve function.
“Even if the intraocular pressure is normal, it does not mean that the optic nerve is absolutely safe. Although some patients have normal intraocular pressure, but the optic nerve damage is found to continue through the examination of the fundus and visual field, the treatment plan needs to be adjusted. A new treatment plan achieves a lower target intraocular pressure and continuously monitors changes in neurological function. Therefore, adherence to treatment and regular follow-up are the top priorities to protect the optic nerve and prevent damage to visual function.” Zhu Siquan emphasized.