Pay attention to eye health, happiness is visible

  On the eve of World Eyes Day on October 10, 2019, the World Health Organization released the first “World Vision Report”. The report pointed out that at least 2.2 billion people worldwide are visually impaired or blind, of which at least more than 1 billion people cannot get the necessary medical or nursing services to solve problems such as myopia, hyperopia, glaucoma and cataracts. The aging of the population, lifestyle changes and limited access to eye care are major factors in the increasing number of visually impaired people.
  As the main morbidity of fundus disease, middle-aged and elderly people should go to the hospital for treatment in time if they develop related symptoms. If treatment is delayed, it is likely to cause irreversible damage and even blindness.
Eye drops can not cure cataracts

  When light enters the human eye, it needs to pass through the lens. If the lens is damaged and becomes dirty, the light will be blocked, making it impossible for people to see objects. This is a cataract. According to the data released by the International Conference on New Advances in Refractive Cataract Surgery in 2018, the incidence of cataracts among people aged 60 to 89 in my country is about 80%, and the incidence of cataracts in people over 90 years old is as high as 90%. Cataract has become a damage to the eyesight of the elderly. The number one killer.
  According to Shu Ming, director of the Optometry Department of Zhongshan Eye Center, Sun Yat-sen University, vision loss is the most typical symptom of senile cataract. However, the blurred vision of cataract patients is the entire field of vision, and is not accompanied by pain and jealous performance. Its occurrence is a process of gradual aggravation. Some elderly people who were not nearsighted before are now beginning to have nearsightedness or vision changes. Some elderly people find that the color contrast between traffic lights is not as obvious as before, and some elderly people find that presbyopia is gone… All of these, be aware that they may have cataracts.
  In addition to ageing factors, clinical findings have shown that people with high blood pressure, diabetes, obesity, smoking, alcohol abuse, sun exposure, long-term exposure to ionizing radiation, eye trauma or surgery history, long-term use of corticosteroids, etc. are more likely to develop cataracts . For those with the above risk factors, it is best to have an eye examination once a year. With cataracts, some drugs can be used to delay the opacity of the lens, but no drugs have been found to cure cataracts. Professor Wu Mingxing from the Zhongshan Eye Center of Sun Yat-sen University said that surgery is the only safe and effective way to treat cataracts. At present, phacoemulsification and femtosecond laser-assisted phacoemulsification can help patients restore vision.
  ”With the increasing demand for cataract surgery and technological innovation, more and more patients are beginning to pursue better postoperative vision and visual quality.” Yao Ke, chairman of the Ophthalmology Branch of the Chinese Medical Association and leader of the National Cataract Group The professor said: “Especially for elderly patients, sharper contrast sensitivity and more continuous visual range can help them reduce the risk of falls and maintain a healthy and energetic life.” Single focal aspherics are currently available on the market. Intraocular lenses, high-end presbyopia correction intraocular lenses, etc., can meet the different visual quality needs of patients. For older patients who need more to see far away, you can choose to implant single-focal intraocular lenses, especially some single-focal intraocular lenses with high contrast sensitivity, which can allow patients to obtain good visual quality, and its price It is cheap and can be reimbursed by medical insurance. High-end presbyopia correction intraocular lenses can simultaneously meet the needs of patients who have to look far and near after surgery.
Reading books always “jump words”, beware of glaucoma

  A person is not called “blind” when he is completely invisible. When the peripheral light is less than 10 degrees, even if he has normal vision, he is still blind. Medically, the range that the eye can see with the “extra light” is called the “field of view”. There are many diseases that damage the visual field, and glaucoma is the most common one. Glaucoma is an eye disease that causes optic nerve atrophy due to intermittent or continuous increase in intraocular pressure. The damage it causes to visual function is irreversible. Statistics show that by 2020, my country will have 21 million glaucoma patients, resulting in nearly 6.3 million blind people and 10 million visually impaired people.
  Glaucoma is relatively hidden in the early stage. In many cases, even if a serious problem occurs in a single eye, it is not easy for everyone to find it, but it does not mean that there is no sign at all. Guo Wenyi, deputy director of the Institute of Ophthalmology, Shanghai Jiaotong University School of Medicine, reminded that the easiest way to find is to read-when reading a book or watching a screen, you always “jump words” or “jump lines”, so pay attention. Although this happens occasionally in ordinary people, if it happens frequently, it may be related to the lack of visual field. Be wary of glaucoma. In addition, some common situations in life should also be paid attention to. For example, you will always hit the door frame when you enter and exit; when you go to the supermarket, you can’t find anything on the shelf; when driving, you often fail to notice the situation on both sides.
  Zhou Shaobo, director of the Ophthalmology Department of the First Affiliated Hospital of Guangzhou Medical University, said frankly that when many patients have symptoms, their vision is already difficult to restore. “It is recommended that people over 50, especially those with eye pain and migraine, add glaucoma examinations to the annual physical examination. It can be screened for more than a hundred dollars.” Glaucoma is like a car without a reverse gear. Although it cannot be reversed, it can brake and decelerate. Timely and correct intervention can completely stop the disease and preserve residual vision. Early-stage patients or open-angle glaucoma can be treated with eye drops. For patients who have already experienced symptoms, if they take laser or surgical treatment as soon as possible, they can also strive for valuable residual visual function.
Diabetes will “attack” the retina, and check the fundus at least once a year

  Currently, nearly 400 million adults worldwide suffer from diabetes, and China has the highest number of patients in the world. The fear of diabetes lies not only in the fluctuation of the patient’s blood sugar, but also in the systemic complications it causes, especially in the eyes. The diabetic retinopathy (abbreviated as “sugar net”) it causes can harm eye health and even cause blindness.
  The “sugar network” early manifested as dilation of retinal venules, microangioma, and retinal hemorrhage, edema, and exudation. At present, there are nearly 109.6 million diabetic patients in China, and about 1/3 of diabetic patients have “sugar net”; about 1/3 of “sugar net” patients have diabetic macular edema, and 1/3 of them have clinical significance Macular edema. It can be said that the main reason that diabetes affects vision in the early stage is diabetic macular edema. As the disease progresses, new blood vessels will appear, which is a bad omen. Because the proliferating new blood vessels will grow along the surface of the retina or enter the vitreous to form a proliferative membrane. When the new blood vessels rupture, it can cause hemorrhage of the retina and vitreous. The contraction of the proliferative membrane can also cause traction retinal detachment. At this time, the patient’s vision is severe. Involved or even blind.
  According to Zhao Mingwei, deputy director of the Department of Ophthalmology, Peking University People’s Hospital, the “sugar net” can be divided into three periods: non-proliferative phase, proliferative phase, and proliferative phase. For the non-proliferative phase, medical treatment is mainly used to control blood sugar, blood pressure, blood lipids, and drugs to improve microcirculation and hemostasis, iodine preparations, etc.; for the proliferation phase, pan-retinal photocoagulation is used to prevent or inhibit the formation of new blood vessels and promote the formation of new blood vessels. The neovascularization subsides to prevent the disease from worsening; for macular edema, laser photocoagulation is possible, and raviolizumab, conbercept or hormone drugs are injected into the vitreous cavity; for long-term vitreous hemorrhage and retinal detachment, vitreous should be performed Incision surgery, intraoperative panretinal photocoagulation.

  Clinical statistics found that more than 50% of diabetic patients in my country did not receive timely eye examinations and early treatment, and did not go to the doctor until their vision was severely reduced, which affected their work or quality of life. At this time, the “sugar net” had reached the proliferation stage. , Delayed the best treatment time. Therefore, in addition to controlling blood sugar, diabetic patients should also undergo regular fundus examinations. The latest version of the Chinese Type 2 Diabetes Prevention and Control Guidelines recommends that patients with non-diabetic retinopathy should be checked every 1 to 2 years; patients with mild non-proliferative retinopathy should be checked once a year, and patients with moderate non-proliferative disease should be checked every 3 to 6 months. 1 time; once every 3 months for patients with severe non-proliferative disease.
Suddenly turning black in front of you, be sure to see the emergency department

  Eyes will also have a stroke? Many elderly patients find it strange to hear the term “eye stroke”. The medical name of “ocular stroke” is central retinal artery occlusion. The pathogenesis is the same as that of cerebral apoplexy. It refers to retinal ischemic necrosis and vision loss caused by blood flow through the central retinal artery.
  Eye strokes often occur in winter, because the cold will stimulate the blood vessels in the eye and cause them to contract, thereby making the eye ischemia, especially in patients with vascular diseases such as hypertension, dyslipidemia, and diabetes. In addition, there are some eye surgeries that sharply increase intraocular pressure and orbital pressure, resulting in retinal artery occlusion; and some patients who have undergone prone general anesthesia find that their eyesight decreases after waking up, or they may have central retinal artery occlusion. . In addition, with the vigorous development of the beauty industry, more and more people are injected with hyaluronic acid and silicon preparations on the face. If the injection is mistakenly entered into the blood vessel, it can also cause the central retinal artery to be blocked.
  Ocular strokes are mostly acute attacks. Generally, the visual acuity of one eye drops suddenly, and the patient’s eyes become dark and invisible. Some patients mistakenly think that it is caused by old age, not taking it seriously, thinking that “a day’s rest should be good.” Doing so will often miss the best treatment time for ocular thrombolysis, causing irreversible damage to visual function. Zhang Hongbing, deputy director of the Eye Hospital of Xi’an First Hospital, said that ocular stroke is a serious and acute blinding eye disease with a blinding rate of up to 80%. 90 minutes is the golden time to rescue patients with central retinal artery occlusion. More than 90 minutes can cause permanent and irreversible damage to the retina, and vision recovery is very slim. Therefore, once the middle-aged and elderly people suddenly suffer from a painless drop or loss of monocular vision, or if they feel blurred vision, darkening all the way from far to near, and finally getting dark, they should go to the hospital for emergency ophthalmic treatment immediately.
New treatment makes macular degeneration “incurable” “curable”

  Seeing something blindfolded? The windows at home are deformed? Look at the clock and find that the hands are curved? This is probably a signal from “age-related macular degeneration”.
  The macula is located in the center of the retina of our eyes. It feels the stimulation of external light, receives signals from external objects, and then transmits to the brain to form vision. It is the most sensitive part of the eye. Macular degeneration refers to diseases in which degeneration occurs in or near the center of the macular area, including drusen, bleeding, exudation, edema, atrophy, scars, etc. Macular degeneration is divided into two types: dry and wet. The dry is manifested as yellow-white punctate lesions after the accumulation of some metabolites. The thinning of the retina in the late macular area leads to atrophy; the wet is manifested by choroidal neovascularization, leading to macular hemorrhage. Edema, exudation, and eventually scar formation.
  The incidence of macular degeneration is related to age, and the older the age, the higher the incidence. “About 90% of patients with general age-related macular degeneration are dry macular degeneration, and 10% are wet macular degeneration.” said Professor Chang Qing, chief physician of the Department of Ophthalmology and doctoral supervisor of the Eye, Ear, Nose and Throat Hospital of Fudan University, “The real harm is Wet macular degeneration with neovascularization, or macular degeneration with atrophy, can cause severe vision loss or even loss of vision.”
  Before 2006, ophthalmologists were almost helpless in the treatment of wet macular degeneration. In the past, people used photodynamic therapy, fundus laser photocoagulation, or surgery, etc., which could only delay the progression of the disease but could not improve the vision of the patient. For example, in the very early days, our method of treating new blood vessels was conventional argon laser. Its purpose was to destroy the new blood vessels, but when the new blood vessels were destroyed, the retina on the new blood vessels would also be destroyed, which would eventually affect vision.
  But it’s different now. In recent years, with the advent of anti-vascular endothelial growth factor (Anti-VEGF) therapy, it can not only block the progression of the disease, but also improve vision and help patients regain their light. This therapy has been recommended by many international clinical guidelines as the first-line treatment for wet age-related macular degeneration. Evidence-based medicine in my country has also confirmed the efficacy and safety of this therapy.
High myopia can cause blindness, must be treated

  The number of myopia patients in my country exceeds 450 million, ranking first in the world. In recent years, high myopic retinopathy has become one of the main causes of irreversible blindness in my country.
  The eye axis of myopia patients is longer than that of ordinary people. The higher the degree of high myopia, the longer the eye axis, and the more obvious the anterior and posterior diameter of the eyeball becomes. Therefore, the eyeball is naturally prominent from a visual point of view. The shape of the human eyeball is similar to that of a balloon. The longer the anteroposterior diameter of the eye axis is equivalent to the larger the diameter of the balloon. The larger the diameter of the balloon, the thinner the balloon. In the same way, when the axis of the eye is elongated, the retina of the eye will become thinner. Therefore, the probability of fundus diseases such as retinal tears, detachment, and macular degeneration is greatly increased. In addition, high myopia may also induce glaucoma, cataracts, etc. These eye diseases may cause blindness. Therefore, it is best for middle-aged and elderly patients with high myopia to undergo fundus screening every six months. If there are lesions in the fundus in the early stage, lasers can be used for appropriate treatment first, which can effectively prevent the deterioration of retinal detachment and avoid serious consequences.
  Professor Yao Ke, director of the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University, reminded that in recent years, many patients with high myopia have undergone corneal laser surgery or intraocular lens implantation to correct their refractive power. However, these operations only make the patients take off their glasses. The fundus changes of myopia have always existed, so such patients should also check the fundus regularly. Professor Chu Renyuan, a well-known optometry expert in my country, pointed out that “protecting the eyes is the key to preventing the formation and deepening of myopia. If you have suffered from myopia, you should take extra care to prevent myopia from evolving into deep myopia and pathological myopia.” In life, patients with myopia should develop good eye-use habits, control the time of reading and eye use, do not lie down and play with mobile phones, take a break when the eyes feel sore, and avoid doing violent explosive exercises.