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 Peng Xi Feng
Ophthalmology
1min 9sec home-news-image

Glaucoma open angle vs closed angle differences

Primary glaucoma is clinically divided into two major categories: angle-closure glaucoma and open-angle glaucoma. The difference between them is that angle-closure glaucoma is due to a pre-existing abnormal configuration of the iris, leading to a mechanical blockage of the anterior chamber angle by peripheral iris tissue, which obstructs the outflow of aqueous humor, thus causing an increase in intraocular pressure. In contrast, open-angle glaucoma has a normal appearance of the anterior chamber angle, which remains open, and its increase in intraocular pressure is due to a pathology in the trabecular meshwork’s aqueous humor outflow system, increasing the resistance to aqueous outflow. Currently, the ratio of primary angle-closure glaucoma to primary open-angle glaucoma is about 3:1, making it the most common type of glaucoma in China.

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Written by Hu Shu Fang
Ophthalmology
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Can glaucoma be contagious?

Glaucoma is not contagious. It is not an infectious disease; rather, it is a group of diseases characterized by increased eye pressure, leading to optic nerve atrophy and vision decline. The most common cause is genetic factors, meaning if elders or parents in the family have this condition, the incidence of glaucoma in their offspring will also be higher. It is an eye disease caused by anatomical abnormalities of the eye. Additionally, some cases of glaucoma are caused by trauma or other reasons, so glaucoma is not contagious.

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Written by Hu Shu Fang
Ophthalmology
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Is it serious if glaucoma causes the pupil to enlarge?

Glaucoma is divided into many types, but the most common are primary angle-closure glaucoma and primary open-angle glaucoma. In these patients, if the pupil dilates or enlarges, the angle of the chamber becomes narrower, leading to increased intraocular pressure, which we refer to as an acute attack of glaucoma. After an attack, patients may experience headaches, nausea, and vomiting. Therefore, it is crucial for glaucoma patients to minimize the time spent in dark rooms to prevent pupil dilation and avoid triggering an acute attack of glaucoma.

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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 Zheng Xin
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.