What are the symptoms of glaucoma precursor?

Written by Peng Xi Feng
Ophthalmology
Updated on September 23, 2024
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The prodromal phase of glaucoma is characterized by transient or recurrent attacks, often occurring multiple times, typically in the evenings. During an attack, patients suddenly experience blurred vision and halos around lights, possibly accompanied by pain in the forehead on the affected side or a sour swelling at the root of the nose on the same side. These symptoms are short-lived and can resolve or disappear after rest. If examined immediately, increased intraocular pressure can be detected, often above 40 mmHg, with slight conjunctival congestion or no congestion. There is mild foggy edema in the corneal epithelium. The anterior chamber is extremely shallow, but the aqueous humor is clear, with a wide closure of the chamber angle, slightly dilated pupils, and sluggish light reflexes. After a minor attack subsides, aside from the characteristic shallow anterior chamber, there generally is no permanent tissue damage.

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Written by Zheng Xin
Ophthalmology
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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.

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Written by Li Zhen Dong
Ophthalmology
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What happens if glaucoma worsens?

Glaucoma, if left untreated or improperly treated leading to worsening, can result in blindness, which is referred to as absolute glaucoma. In such cases, it becomes impossible to recover vision; in other words, it is irreversible. Therefore, it is crucial to proactively treat glaucoma after its onset by reducing eye pressure to protect vision, adjusting one's mindset, resting adequately, and avoiding close-range activities. The treatment is generally quite successful nowadays. Glaucoma can be classified into acute angle-closure glaucoma and open-angle glaucoma, both of which are types of primary glaucoma. Additionally, it can be categorized into primary glaucoma, secondary glaucoma, congenital glaucoma, and mixed glaucoma. With active treatment, the outcomes for glaucoma are generally good.

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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 Peng Xi Feng
Ophthalmology
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The difference between open-angle and closed-angle glaucoma

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 Dong Xian Yan
Pediatrics
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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.