There is an eye disease that does not slowly blur vision like cataracts, nor does it cause severe headaches and eye pain like acute glaucoma. It is silent, painless, like a clever thief who steals vision little by little when people are unaware. Until one day, the patient suddenly found that there was only a small piece of light in the center in front of his eyes, and the lost light could never be regained.

This "thief" is chronic angle-closure glaucoma. In our country, it is one of the main causes of irreversible blindness. The most terrifying thing about it is that it is extremely hidden, but its "modus operandi" is not without traces.

The "water cycle" in the eyes is chaotic

To understand how chronic angle-closure glaucoma "steals" vision, we must first briefly understand the internal structure of the eye. You can think of the eyes as a sophisticated sink: there is a structure called the ciliary body in the eye, like a "faucet" that never closes the gate, constantly secreting aqueous humor and delivering nutrients to the eyes; After the aqueous water is used up, it should be discharged out of the eyes through the "sewer" in the corner of the room; The water inlet of the "faucet" and the water from the "sewer" must be balanced to maintain the normal pressure in the eyeball, that is, intraocular pressure. If the intraocular pressure is too high, it will compress and damage the optic nerve, which is the root cause of most glaucoma.

Chronic angle-closure glaucoma is that the entrance to the "sewer" is blocked, but the "faucet" is still producing water, and the balance between water inflow and outlet in the eye is broken, and there is more and more water in the eye, and the intraocular pressure will continue to rise.

So what makes the "sewer" close? It turns out that the intraocular pattern of such patients is naturally relatively compact, such as the eyeball is small, or the lens inside is thick, which will push the iris - the colored part of the black eye - forward little by little. The iris is like a curtain, slowly covering the "sewer" entrance to the corner. This process is gradual, so the patient's intraocular pressure does not spike as suddenly as in an acute attack, but rises slowly and fluctuately.

Sometimes, in a dimly lit environment, such as when watching a movie, the pupils will dilate and the iris will accumulate, which may temporarily block the "sewer"; When you return to the bright place or rest for a while, it will return to normal. Patients may feel that their vision is transient blurred or rainbow circles appear when looking at lights, and these minor symptoms are too easy to ignore. It was this "micro-attack" that gradually caused the entrance of the "sewer" to gradually produce permanent adhesions, and finally completely closed, and the optic nerve was slowly crushed by the continuous high pressure unconsciously.

Vision Thief" target preference

This "vision thief" is not a random person to attack, it has a clear target preference. If you meet the following characteristics, you have to be extra vigilant.

Middle-aged and elderly people over the age of 45 should pay attention to the fact that as they age, the intraocular lens will naturally thicken, the ocular space that may be crowded will be more crowded, and the risk of "sewers" being blocked will also increase. Women have a much higher risk of developing the disease than men, which may be related to the fact that women's eyeballs are usually smaller. If someone in the family has had angle-closure glaucoma, such as parents or siblings, the probability of the disease will be much higher than that of ordinary people.

There is also one of the most overlooked features - farsightedness or precocious presbyopia. Patients with farsightedness usually have a short eyeball axial diameter and a naturally crowded intraocular space, which is a typical high-risk group for angle-closure glaucoma. Therefore, those who have very good eyesight when they are young and are known as "clairvoyants", but need to wear reading glasses in their early 40s, must be highly vigilant.

Simple screening for risks at home

Since chronic angle-closure glaucoma is caused by a structural defect, can this defect be detected before it causes damage? The answer is yes, and the method is very simple, you can check on each other with your family at home.

This method is called "flashlight side illumination method". The person being examined looks straight ahead, and the person next to him holds a flashlight (mobile phone flash can also be used), shines horizontally on the eyeball from the temple side of the examinee's eye, and then observes the iris near the nose, which is the black eyeball.

If the entire iris can be illuminated, it means that the space inside the eye is relatively spacious and the risk is relatively low, which is a safety signal. However, if the iris near the nose is clearly shadowed, about 2/3 or more of the area is dark, like a mountain blocking the light, which is a red flag, indicating that the space in the eye is very crowded and the risk of "sewers" being blocked is high.

Once this iris shadow is found, it is necessary to go to the hospital as soon as possible to find an ophthalmologist for further examination. This simple screening method is especially suitable for initial screening in the community and at home, and can identify many potential patients from the crowd.

Three ways to resolve "crowding"

If the diagnosis is confirmed through professional examination, don't panic, the doctor will formulate a treatment plan of "building the road first and then regulating the pressure" according to the specific situation of the "sewer blockage".

The first trick is laser punching, opening up new paths. This surgery, medically known as laser peripheral iridotomy, can be said to be a revolutionary method for the treatment of angle-closure glaucoma. The doctor will use a special laser to make a small hole in the iris that is almost invisible to the naked eye, which is like opening an emergency evacuation channel in a crowded room, which can allow the aqueous humor to flow smoothly around the blockage, the pressure in the eye will be instantly relieved, and the iris that arches forward will also fall back and reopen the entrance to the "sewer". The whole process can be completed in the outpatient clinic and only takes a few minutes, which is currently the preferred treatment method for patients.

The second trick is to maintain it continuously with eye drops. Some patients have permanent adhesion damage to the "sewer" after laser treatment, and the intraocular pressure is still high, at this time, the doctor will prescribe eye drops. These eye drops can either reduce the amount of water from the "faucet" or improve the efficiency of other auxiliary drainage routes, which can help patients stabilize intraocular pressure within a safe range for a long time.

The third move is surgery, the ultimate transformation. For patients with severe illness or cataracts at the same time, surgery is a more effective treatment. In particular, cataract combined with angular dissection surgery is of great significance to patients with angle-closure glaucoma. The operation is not only to change the clear "lens", but also to replace the thick, space-occupying natural lens with an ultra-thin intraocular lens, which can greatly expand the intraocular space and fundamentally solve the problem of crowding. After that, the doctor can also accurately find the position of the "sewer" closed through the gonioscope during the operation, and dredge it in a special way, which can be said to solve the problem of increased intraocular pressure once and for all.

Although chronic angle-closure glaucoma is dangerous, it is not invincible. Its "lifeline" lies in the fact that the anatomical abnormalities that cause the onset of the disease can be detected early. Our strongest weapon against it is to understand it and act in time. Please tell these knowledge points to your relatives and friends, especially those female elders who have excellent eyesight and presbyopia. In this battle to defend the light, victory always belongs to those who act early.