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首页> 外文期刊>BMJ: British medical journal >Preventing blindness from glaucoma Better screening with existing tests should be the priority
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Preventing blindness from glaucoma Better screening with existing tests should be the priority

机译：防止失明青光眼更好与现有的测试应该筛查优先级

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The detection and management of primary open angle glaucoma is a major healthcare issue. It is the second largest cause of blindness in the world and affects some 66.8 million people, leaving 6.7 million with bilateral blindness.1 hi the United Kingdom, the ageing of the population means that the number of cases is expected to increase by 30% in the next 20 years.In primary open angle glaucoma, the retinal ganglion cells-the nerves that carry the visual stimulus from the retina to the brain-undergo apoptosis after insult at the head of the optic nerve. The progressive loss of ganglion cells leads to characteristic structural changes at the head of the optic nerve and functional loss to the visual field. Glaucoma is often, but not necessarily, associated with raised intraocular pressure. A paper in this week's BMJ shows that, in general, treatment to reduce intraocular pressure leads to delayed progression of visual field loss in patients with manifest open angle glaucoma.3 More research is needed in the subgroup of patients without increased intraocular pressure, to determine which patients with normal tension glaucoma will benefit most, since this meta-analysis was unable to show a consistent benefit in these patients.3 In 1982 Grant and Burke wrote a paper intriguingly titled "Why do some people go blind from glaucoma?"4 From a sample based in the United States, they found that some 30% of people who go blind from this disease are blind, in both eyes, at presentation. Most of the blind patients were aware of their decreasing vision for months, or even years, before they sought medical advice. Blindness was defined as an acuity of less than 20/200 (< 6/60 metric Snellen) in the better eye, or a residual visual field of less than 10 degrees. In a more recent report by Sinclair,5 who investigated registrations for blindness due to glaucoma in Fife between 1990 and 1999, a considerable number of patients were found to have moderate to advanced visual field loss at their first appointment, with 23% being eligible for registration as blind.
机译：主要的检测和管理开放的角度青光眼是一个主要的医疗保健问题。失明的第二大原因和影响大约6680万人,6.7百万与双边失明。王国,人口老龄化意味着病例数预计将增加未来20年的30%。青光眼、视网膜神经节细胞的神经携带视网膜的视觉刺激后brain-undergo凋亡侮辱的视神经。神经节细胞导致的结构性特征视神经和变化功能视野损失。通常,但不一定,联系在一起引起眼内压。本周BMJ表明,一般来说,治疗降低眼内压会导致延迟患者的视野损失清单开角glaucoma.3没有需要的子群病人眼内压增加,来确定青光眼患者正常的张力将受益最大,因为这个荟萃分析是不能在这些patients.3显示一致的利益1982年,格兰特和伯克写了一篇论文有趣的是名为“为什么有些人失明从青光眼?美国,他们发现,有30%的人从这种疾病是盲人失明,在吗眼睛,在演讲。是意识到自己的视力下降好几个月,甚至几年,之前他们寻求医疗建议。失明是指不到的敏锐度20/200(< 6/60度规Snellen)更好的眼睛,或小于10的残余视野度。谁为失明由于调查登记青光眼在1990年和1999年之间的横笛,相当数量的患者被发现有中度到先进的视野损失吗他们第一次约会,23%合格注册为盲人。

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