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Glaucoma
What are the symptoms of a glaucoma attack?
Typical acute angle-closure glaucoma has several different clinical stages, divided into the preclinical stage, prodromal stage, acute attack stage, intermittent stage, chronic stage, and absolute stage. The acute attack stage is mainly characterized by severe headache, eye pain, photophobia, tearing, and significant deterioration of vision, often reduced to counting fingers or hand motion, and may be accompanied by systemic symptoms such as nausea and vomiting. Physical signs include eyelid edema, mixed congestion, corneal epithelial edema, and the appearance of small droplets under the slit lamp. Patients may complain of rainbow vision, which primarily occurs due to the large number of small vesicles in the swollen corneal epithelium and the spaces between epithelial cells.
Can children have glaucoma?
Children can develop glaucoma. Congenital glaucoma typically presents within the first year of life and is more common in boys. The disease onset before the age of two to three years leads to increased eye pressure, which results in the enlargement of the eyeball. This manifests as photophobia, tearing, and eyelid spasms. Once diagnosed, early surgical treatment is recommended. For children under three years old, the preferred surgical procedures are trabeculectomy or goniotomy. As children are in a developmental stage and have poorer overall tolerance, anti-glaucoma medications are only suitable for short-term bridging treatment.
Does glaucoma require surgery?
There are many types of glaucoma, such as primary angle-closure glaucoma, open-angle glaucoma, and normal-tension glaucoma. Once glaucoma is definitively diagnosed, medication can be used first to control intraocular pressure. If medications cannot control the pressure, surgery may be considered. However, generally, if it is early stage, and there is no damage to vision or visual field, with not very high intraocular pressure, medication can be considered first. If the intraocular pressure remains very high, medication fails to stabilize it, and there is a decline in vision or damage to the visual field, then surgery is needed.