Look at things deformed, be careful of macular edema! Daily health adjustment focuses on three points ~
"Source of this article: Capital Traditional Chinese Medicine"
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Recently, I received a 56-year-old female patient in the outpatient clinic: "Doctor, my eyesight used to be very good, but the other day I saw things suddenly deformed." Now I see that the straight line on the wall is curved, and some things were originally big, but I look smaller. And I can’t see clearly. What’s going on? " The patient said and gestured with his hand.
According to the description, I estimate that the patient may have macular problems. After further inquiry, I learned that the patient had a history of hypertension. A few days ago, he was overworked and stressed, and his blood pressure increased significantly. The author gave her a special examination of fundus, and sure enough, she found fundus hemorrhage and macular bulge. The diagnosis was macular edema, secondary to retinal vein occlusion.
What is macular edema?
Macula is located in the center of the fundus, which is similar to the position of the target’s bull’s-eye 10 ring. It is called macula because it is yellow when dissected. Macula occupies less than 5% of the retina, but it is the center of the most acute vision. The vision we usually measure is the visual function of the macular center. Macula has a very special function, which can distinguish the color, fine shape and brightness of an object, detect the distance of the object and follow the movement of the object.
Visual distortion is mostly related to macular degeneration. Macular degeneration, macular hole, epimacular membrane, mesoosmosis and macular hemorrhage caused by various reasons can also cause visual distortion. Macular edema is one of the chief culprits of visual distortion. Macular edema is a kind of fundus disease that often occurs in middle-aged and elderly people and seriously threatens visual function, but it is not an independent eye disease. Its main symptoms are visual distortion and decreased central vision.
Macular edema can be divided into cystoid macular edema and diffuse macular edema. Often secondary to retinal vein occlusion, diabetic retinopathy, retinal vasculitis, uveitis and cataract after intraocular surgery. Many diseases cause the increase of retinal capillary permeability, the damage of blood-retinal barrier, and the accumulation of fluid between the outer plexiform layer and the inner nuclear layer of the retina, resulting in macular retinal edema.
With the aging of China’s population, the incidence of eye diseases among middle-aged and elderly people has increased, and the number of patients with macular edema has also increased. Long-term non-healing of macular edema can cause photoreceptor apoptosis and irreversible loss of vision, which leads to decreased vision and distortion of vision, which has caused great trouble to patients’ life and work.
Fundus fluorescein angiography is the gold standard for the diagnosis of macular edema. Modern medicine mostly thinks that vascular endothelial growth factor (VEGF) and inflammation are the two main pathogenic pathways of macular edema. At present, the main means of treating macular edema in modern medicine are VEGF therapy, hormone, laser photocoagulation, surgery and non-steroidal anti-inflammatory drugs.
Understanding of ancient and modern Chinese medicine
Ancient doctors couldn’t see the patient’s fundus because they didn’t have an ophthalmoscope, so there was no record of macular edema in ancient literature. According to its clinical symptoms, it should be classified as "seeing straight as a curve" and "seeing the big as small".
The name of "seeing straight as a curve" first appeared in "Seven Tips for Treating Syndrome". The book said: "Seeing straight things as a curve, bowstring rulers and the like, all of them are like hooks." It belongs to the scope of illusion. There is no new expression in the description of straight sight in the later literature. The "Diagnostic Efficacy Standard of TCM Diseases" states: "Seeing straight and crooked is an eye disease in which things with straight vision, such as crooked eyes, are caused by maladjustment of clothing, body fluids and blood overflowing collaterals."
The causes of straight vision are described in detail in ancient books. "Examining Yao Letters and Misconceptions" states: "If the length is short, the white is black, the confusion is reversed, and the divine light is dark, then the essence will decline and change." It is considered that the essence is scattered and cannot be above the eyes, which can lead to delusion. Sun Simiao put forward that "spleen-stomach deficiency leads to nine unknowns" in "Prescription for Preparing a Thousand Daughters for Emergency", and summarized the mechanism of spleen deficiency leading to eye diseases. "The Golden Mirror of Ophthalmology" states: "Those who regard the big as small and the red as white, the onset of this disease is also caused by the stagnation of heat and evil in liver and kidney for a long time."
Modern Chinese medicine scholars think that macular edema is closely related to liver, spleen and kidney. Etiology includes primary cause, secondary cause and inducing factors. As inducing factors, exogenous wind-heat (wind-toxin) and improper diet can all cause or aggravate spleen deficiency, making it abnormal in transportation, improper in ascending and descending, and imbalance in collaterals and qi and blood, which in turn leads to superior yin fire, turbid phlegm, stagnant blood, macular edema, exudation and bleeding, and the symptoms of straight vision appear.
Traditional Chinese medicine has the advantages of definite curative effect, non-invasion, non-trauma, high cure rate, low recurrence rate and relatively low cost in the prevention and treatment of macular edema.
Daily health adjustment
Physical factors, internal and external environment of the body, emotion and other comprehensive factors play an important role in the pathogenesis of macular edema. Therefore, it is very important to do a good job in health care, which can prevent disease before it happens and prevent it from changing.
Control risk factors
Hypertension, diabetes and hyperlipidemia are high risk factors for macular edema. Patients with macular edema should pay attention to reasonable diet, smoking and alcohol restriction, and weight control in daily life to prevent the occurrence of hypertension, hyperlipidemia and diabetes. Patients who have been diagnosed as "three highs" should actively treat the primary disease, control blood sugar, blood pressure and blood lipid in a safe and reasonable range, and have regular eye examinations. Once early changes are found, intervention measures should be taken as soon as possible to prevent the delay from aggravating the condition. Self-test can also be carried out at ordinary times. If you find abnormal conditions such as decreased vision, deformed or reduced vision, and shadow occlusion in front of your eyes, you should go to the hospital in time.
Diet conditioning
Develop good eating habits and maintain a balanced nutrition. To control the total diet and optimize the structure. Eat vegetables, fruits, fish and nuts regularly, and choose foods with the functions of warming stomach, soothing liver and tonifying kidney according to physical conditions. Wax gourd, towel gourd, bitter gourd and amaranth have the functions of clearing away heat and toxic materials, inducing diuresis to reduce swelling, promoting blood circulation and dredging collaterals, so you can eat more with staple food. Lotus plumule and Dioscorea opposita can nourish the mind, tonify the kidney and benefit the lung, and you can also choose Coicis Semen, Euryale Semen, Semen Phaseoli and other decoctions or porridge to eat.
Harmony of seven emotions
Keep your mind inside, calm your nerves and avoid severe and bad emotional stimulation. Arrange work and life in a planned way, reduce work pressure and tension, so as not to get anxious and get angry, causing or aggravating illness. Adjusting mentality, moderate exercise and peace of mind treatment are helpful to mobilize healthy qi and promote rehabilitation.
Content source: China Chinese Medicine News.
Author: Feng Jun, Eye Hospital of Chinese Academy of Traditional Chinese Medicine
Editor: Wang Di
Audit: Zhu Yan
"Capital TCM" ID:
bjtcm010
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