60-year-old uncle Yang after the right eye almost blind! Doctors: this type of people are more frequent, recently have received dozens of cases

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According to Shangguan News, these days the topic related to “Yang” has been on the hot search from time to time, and every detail seems to attract attention, which comes from the most simple attention to health and life of each person.

Chen Shu (a pseudonym), 60, of Hangzhou, had a sudden severe headache and eye pain after “Yang”, and thought it was a new crown symptom. ZJUH reminds us that during the epidemic, we should try to go to the hospital as little as possible, but some diseases should not be delayed.

A 60-year-old man suddenly had a headache after “Yang”

It turned out to be a problem with his eyes

“Doctor, I have a headache, my right eye hurts, and I can’t see well.” In the outpatient clinic of Dr. Sun Yuan of the First Hospital of Zhejiang University School of Medicine, 60-year-old Uncle Chen walked into the consultation room and said painfully before he sat down.

It turned out that Uncle Chen had contracted the new coronavirus a few days ago and had fever, sore throat and cough. Uncle Chen, who is usually in good health, thought that it was still a problem after the new coronavirus infection, so he wanted to carry it at home. The headache became more and more severe and he could not sleep, so he rushed to the ophthalmology clinic at the Qingchun Campus of Zhejiang University.

Dr. Sun Yuan perfected the eye examination for Uncle Chen and found that his right eye was almost blind and the intraocular pressure was so high that it could not be measured by the machine. After ruling out various diseases, Uncle Chen was diagnosed with acute angle-closure glaucoma in his right eye, and the sharp increase in intraocular pressure caused severe pain and vision loss.

The team of ophthalmologists immediately provided Uncle Chen with targeted emergency treatment and performed an emergency right anterior chamber puncture for him to minimize the risk of damage to the optic nerve when medication could not control the IOP. After timely and precise treatment by the team of ophthalmologists, Uncle Chen’s right eye pressure came down, pain was much reduced, and some vision was restored, and he has been hospitalized for further follow-up treatment.

New crown induced glaucoma?

The truth is ……

“Acute angle-closure glaucoma is a type of glaucoma due to the sudden closure of the anterior chamber angle, the atrial water drainage channel in the eye, resulting in a sharp increase in intraocular pressure. It is a serious blindness and an ophthalmic emergency. Patients are often farsighted, have a short eye axis, shallow anterior chamber, narrow anterior chamber angle, thick and anterior lens and other anatomical features.” Dr. Rong-Rong Hu, deputy chief of ophthalmology, said.

Under normal circumstances, the water in the tank flows in and out smoothly, keeping a certain pressure in the eye, but a glaucoma attack is a problem with the tank for various reasons, and the water in the tank does not flow out, resulting in increased pressure.

Like Uncle Chen after examination, his own eye atrial angle structure is narrower than the average person, more easily “blocked”, so that the atrial water only into not, “overflow”, resulting in a sharp increase in intraocular pressure. The best solution for treatment is to first lower the eye pressure, and then reopen the “outlet”, so that the water tank to resume normal operation.

Recently, the ZJU Eye Center has seen dozens of patients with acute closed-angle glaucoma attacks. Hu Rong Rong, deputy chief physician, said, compared to usual, these patients glaucoma attack more acute, more serious, many patients even both eyes at the same time. In addition to the patient’s original anatomical basis, neocoronavirus infection factors have a definite impact:.

1, hyponatremia

Some patients with neoconiosis develop hyponatremia (serum sodium <135 mMol/L) due to renal impairment associated with viral infection or other reasons such as heavy water consumption. The reduced blood sodium level causes a change in the original blood/atrial water osmolarity gradient, which in turn increases atrial water secretion and leads to an increase in intraocular pressure.

2、Prolonged prone position

Prone position can help patients with neoconus to improve the symptoms of chest tightness and shortness of breath and facilitate sputum excretion, which is an important measure to stop patients with common type of neoconus from turning into heavy. However, in people with glaucomatous anatomical characteristics, prolonged prone position ventilation may lead to acute closed-angle glaucoma attacks due to the forward displacement of the crystal iris diaphragm position associated with gravity factors.

Use of cough suppressant and asthma medications

Commonly used cough suppressant and asthma medications, such as Asmec (compound methocarbamol), Advil (ipratropium bromide), Benadryl, salbutamol, etc., have certain pupil-dilating components and should be used with caution in patients with anterior chamber angle stenosis. Also included are nasal decongestants, such as pseudoephedrine.

In addition, in the current epidemic, adverse emotions such as tension and anxiety, prolonged home viewing of cell phones, visual fatigue, fever, inflammatory stimulation, and heavy drinking may also trigger the onset of acute angle-closure glaucoma.

Cui Hongguang, director of ophthalmology at ZJU, said that the new coronavirus infection may lead to orbital pain in some patients, so we don’t need to be particularly nervous and can observe it first. However, if symptoms such as episodes of eye redness and pain, eye swelling, blurred vision, red and green halos when looking at lights, and soreness at the root of the nose occur, you should go to a professional ophthalmology clinic in time. In addition, if there are black shadows in front of the eyes, sudden loss of vision, and severe pain in the eyes, you should also seek medical attention in time to avoid delaying the condition.