The difference between open-angle and closed-angle glaucoma

Written by Peng Xi Feng
Ophthalmology
Updated on September 18, 2024
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Primary angle-closure glaucoma is a type of glaucoma caused by the peripheral iris blocking the trabecular meshwork, or permanently adhering to the trabecular meshwork, obstructing the outflow of aqueous humor, leading to increased intraocular pressure. It is characterized by a narrow angle and the anatomical feature of the peripheral iris being prone to contact with the trabecular meshwork. Gonioscopy confirming angle closure is an important diagnostic criterion. The characteristic of open-angle glaucoma, however, is that even though intraocular pressure is elevated, the angle remains open, with the obstruction of aqueous outflow occurring at the trabecular meshwork system.

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Written by Zhou Qing
Ophthalmology
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Early symptoms of glaucoma

Glaucoma is a condition where the intraocular pressure exceeds the tolerance limits of the tissues within the eyeball, especially the optic nerve, causing characteristic optic nerve atrophy and visual field defects. In the early stages of glaucoma, the following symptoms may occur: First, there is eye pain, which may also be accompanied by headaches; Second, transient phenomena of rainbow vision or foggy vision, resembling the appearance of rainbow-like halos around light sources such as light bulbs; Third, there is a family history of glaucoma, especially if suspicious symptoms are present; Fourth, the eyeball becomes harder, and may feel as hard as a stone. Fifth, unexplained decrease in vision or visual field defects. Some glaucomas have atypical early symptoms, but the presence of the above symptoms should be taken seriously and prompt a hospital visit for diagnosis. High-risk groups for glaucoma should undergo annual eye exams to prevent the disease.

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Written by Li Zhen Dong
Ophthalmology
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How to rule out glaucoma with high eye pressure?

Normal intraocular pressure ranges from 10-21mmHg. If it exceeds 21mmHg, it is considered to be increased intraocular pressure. Main symptoms of high intraocular pressure include eye distension, eye pain, tearing, photophobia, blurred vision, nausea, vomiting, headache, etc. High intraocular pressure is a primary diagnostic criterion for glaucoma, but it is not the only standard. Glaucoma can be divided into primary glaucoma, secondary glaucoma, congenital glaucoma, and mixed glaucoma. Primary glaucoma can further be subdivided into open-angle glaucoma and angle-closure glaucoma. Only during an acute attack of angle-closure glaucoma does the intraocular pressure increase, whereas open-angle glaucoma generally does not affect intraocular pressure. Therefore, the diagnosis of glaucoma mainly relies on a comprehensive assessment of the angle of the anterior chamber, intraocular pressure, visual field, visual acuity, and the condition of the optic disc.

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Written by Hu Shu Fang
Ophthalmology
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What are the symptoms of glaucoma?

Glaucoma refers to a group of eye diseases characterized by increased eye pressure, leading to optic nerve atrophy and vision loss. The symptoms of glaucoma are mainly caused by increased eye pressure, resulting in eye pain. In cases of acute angle-closure glaucoma, symptoms include eye pain along with nausea, vomiting, photophobia, and tearing, which can easily be mistaken for neurological diseases. Chronic glaucoma symptoms, such as headache, nausea, and vomiting, are less pronounced, and eye discomfort is also more concealed during attacks, making early detection difficult. Therefore, it is important for glaucoma patients to undergo early examination and diagnosis, and to receive appropriate treatment in order to protect the optic nerve and prevent severe vision loss.

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Ophthalmology
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Glaucoma Precautions

Once glaucoma is confirmed, active treatment is necessary, such as medication or surgery. In daily life, the following points should be noted: First, do not stay in dark environments for a long time. Second, avoid excessive use of eyes and ensure to rest. Third, try to avoid drinking strong tea or coffee and do not drink a large amount of water at once. Fourth, avoid using drugs that can trigger glaucoma attacks, such as antispasmodics and antidepressants.

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Is vitreous opacity a precursor to glaucoma?

Vitreous opacities are not a precursor to glaucoma. Vitreous opacities can be divided into physiological and pathological types. Physiological vitreous opacities generally do not affect vision, and one may see variously shaped black shadows in front of the eyes. Pathological vitreous opacities can impact vision and should be further examined by an ophthalmologist. The precursors of glaucoma include eye pressure, eye pain, photophobia, tearing, relief after rest, and a decrease in vision, along with halos seen around lights. If these symptoms occur, active treatment should be sought. Glaucoma can be classified into primary, secondary, congenital, and mixed types.