Sen Saswati, Das Matuli, Das Manmath Kumar, Dash Snehalata
Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
J Family Med Prim Care. 2022 Apr;11(4):1410-1415. doi: 10.4103/jfmpc.jfmpc_1371_21. Epub 2022 Mar 18.
The aim of this study was to assess the ocular morbidity due to delayed presentation in glaucoma patients because of COVID lockdown.
This was a retrospective study of 15 cases presented to us between October 2020 and February 2021. Cause of glaucoma in our study group was either primary angle closure, pseudoexfoliation, lens-induced glaucoma, or neovascular glaucoma. The cause of delayed presentation was identified and patients were treated with antiglaucoma medications, Nd-Yag laser, and surgery as per the standard treatment protocol.
With both medical and surgical intervention, some useful vision was restored in five cases while in rest it was not salvageable. The vision in the affected eye ranged from 6/60 in Snellen's chart to perception of light and projection of rays positive. Better results were achieved in angle, closure, and lens-induced glaucoma cases as compared to neovascular glaucoma cases.
The time of presentation in such cases is as important as the etiopathogenesis. We are left with limited treatment options if the presentation is late. The lockdown ended but it unraveled quite a few instances of disease presentation which were totally preventable under normal circumstances. Introspection on finding out newer and proactive methods to reach people suffering from such irreversible but preventable diseases is the need of the day especially when preventable but irreversible diseases like glaucoma are considered.
本研究旨在评估因新冠疫情封锁导致青光眼患者就诊延迟所引发的眼部疾病情况。
这是一项对2020年10月至2021年2月间收治的15例患者的回顾性研究。研究组中青光眼的病因包括原发性闭角型青光眼、假性剥脱性青光眼、晶状体诱导性青光眼或新生血管性青光眼。明确就诊延迟的原因，并根据标准治疗方案对患者使用抗青光眼药物、钕钇铝石榴石激光及手术进行治疗。
通过药物和手术干预，5例患者恢复了一定有用视力，其余患者视力无法挽救。患眼视力在斯内伦视力表上从6/60到光感及光线投射阳性不等。与新生血管性青光眼病例相比，原发性闭角型青光眼、晶状体诱导性青光眼病例取得了更好的治疗效果。
在此类病例中，就诊时间与病因发病机制同样重要。如果就诊延迟，我们的治疗选择将十分有限。封锁结束了，但它揭示了不少疾病就诊情况，而这些情况在正常情况下是完全可以预防的。当下需要反思，找到更新、更积极的方法来帮助患有此类不可逆转但可预防疾病的患者，尤其是在考虑像青光眼这种可预防但不可逆转的疾病时。
