What Is Glaucoma？
Is Glaucoma Treatable?什么是青光眼 ？
青光眼能根治吗？

Glaucoma—specifically Primary Open-Angle Glaucoma (POAG)—is widely known as the "silent thief of sight" because it develops without pain, redness, or early central visual loss.

The disease targets the peripheral (side) visual field first. Because your eyes have overlapping fields of view and your brain automatically fills in missing visual information, you will not notice subtle peripheral blind spots in daily life. By the time a patient notices reading difficulties or "tunnel vision," up to 50% or more of the retinal ganglion cell nerve fibers may already be permanently destroyed. Regular clinical optical evaluations (OCT scans and visual field tests) are the only way to detect these invisible early optic nerve changes before permanent loss occurs.

青光眼（尤其是最常见的原发性开角型青光眼）被称为“隐形视力杀手”，正是因为它在发病初期完全没有任何疼痛、发红或中心视力下降。

青光眼最早侵犯的是您的周边（余光）视野。由于双眼视野存在重叠，且大脑具有强大的视觉自动填补功能，您在日常生活中根本无法察觉边缘区域微小的盲点。当患者自己感觉到看东西像“管状视野”或阅读困难时，通常已有高达 50% 以上的视神经纤维发生了不可逆的死亡。因此，定期进行眼科专项检查（如 OCT 视神经扫描与视野检查）是唯一能在视力受损前捕获病变的方法。

Yes. Elevated intraocular pressure (IOP) is the strongest modifiable risk factor for glaucoma, but it is not the sole cause of the disease.

Patients who develop progressive optic nerve cupping and visual field loss despite statistically normal IOP readings (typically ≤ 21 mmHg) have a subtype known as Normal-Tension Glaucoma (NTG). In these individuals, structural factors (such as an extra-sensitive or thin lamina cribrosa) or vascular dysregulation (poor microvascular blood supply, low nocturnal blood pressure, or vasospasm) cause cellular stress to retinal ganglion cells even under standard pressures. Treatment for NTG still focuses on lowering the baseline IOP even further to remove stress from the vulnerable optic nerve.

是的。虽然高眼压是青光眼最重要的危险因素，但它并不是导致该病的唯一原因。

如果患者的眼压测量值在统计学正常范围内（通常 ≤ 21 mmHg），但视神经却持续出现凹陷加深和视野缺损，这被称为正常眼压性青光眼（NTG）。这类患者通常存在视神经筛板结构过于脆弱、或眼底微循环调节障碍（如夜间低血压、血管痉挛导致视神经缺血）。即便眼压“正常”，对其脆弱的视神经来说依然偏高。因此，治疗上依然需要将其眼压在基础值上进一步压低，以保护视神经。

No. Glaucoma treatments cannot cure the disease or reverse past visual loss, but daily medications are vital to protect the vision you currently have.

Retinal ganglion cells and optic nerve fibers cannot regenerate once they undergo apoptosis (cell death). Modern therapies—whether prostaglandin eye drops, beta-blockers, or laser interventions—work by lowering intraocular pressure to slow down or halt future nerve degeneration. Adherence to your daily eye drop regimen is mandatory because stopping medications causes IOP to rebound, exposing remaining optic nerve fibers to ongoing mechanical and vascular damage.

不能。现有的青光眼治疗手段无法“根治”该病，也无法逆转已经丧失的视力，但坚持用药对于保住您现有的视力至关重要。

人类的视网膜神经节细胞和视神经纤维一旦死亡（凋亡），目前科学水平下是无法再生的。无论是前列腺素类眼药水、β受体阻断剂还是激光治疗，其核心作用都是通过降低眼内压，来止血防损、遏制未来视神经的进一步退化。严格遵医嘱每日滴药至关重要，因为擅自停药会导致眼压回升，使剩余尚存的视神经重新暴露于高压损伤之下。

SLT is an in-office, non-invasive laser therapy, whereas Trabeculectomy is an invasive surgical operation reserved for advanced or uncontrolled glaucoma.

Selective Laser Trabeculoplasty (SLT): Delivers low-energy laser pulses to the trabecular meshwork to stimulate natural cellular remodeling and improve fluid drainage. It is painless, performed in minutes, carries minimal risk, and can serve as a primary or adjunctive treatment.

Trabeculectomy & Shunts: Surgery that creates a brand-new filtration pathway (a "bleb") directly from the anterior chamber to allow aqueous humor to drain out beneath the conjunctiva. This is performed in an operating theater when maximum eye drops and laser therapies fail to control IOP.

SLT 是一种在门诊即可完成的非侵入性激光疗法，而小梁切除术则是针对中晚期或药物无法控制的青光眼所实施的创伤性外科手术。

选择性激光小梁成形术（SLT）： 采用低能量激光照射小梁网，刺激其自我重塑并改善房水自然引流。无痛、几分钟即可完成，并发症极少，常作为一线或补充治疗。

小梁切除术与引流阀植入术： 通过手术在眼球壁上建立一条全新的引流通道（滤过泡），将房水直接引流至结膜下隙。这属于手室手术，通常在药物和激光均无法平稳控制眼压时使用。

These are textbook symptoms of an Acute Angle-Closure Glaucoma (AACG) attack, which can cause permanent blindness within hours if untreated.

During an acute attack, the peripheral iris physically locks forward against the cornea, completely blocking the drainage angle. Intraocular pressure spikes rapidly from a normal ~15 mmHg to dangerous levels over 50-70 mmHg. This extreme pressure causes severe corneal edema (creating rainbow halos around lights), intense head/eye pain, nausea, and rapid ischemia of the optic nerve. Emergency treatment—including intravenous pressure-lowering agents and Laser Peripheral Iridotomy (LPI) to punch a relief bypass in the iris—must be administered immediately to relieve the pressure spike.

这些是“急性闭角型青光眼”发作的教科书式症状，如果不立即救治，可在数小时内造成永久性失明。

急性发作时，周边虹膜物理性向前贴附在角膜上，彻底封堵了房水引流角。眼压会在短时间内从正常的 15 mmHg 左右飙升至 50-70 mmHg 以上的危重水平。这种超高眼压会导致角膜严重水肿（看灯光出现彩虹般的虹视）、眼头剧痛、恶心呕吐，并使视神经发生急剧缺血坏死。这需要立即进行急诊干预——包括静脉降眼压药物及激光虹膜周切术（LPI）在虹膜上打孔减压，以挽救视力。