Glaucoma open angle vs closed angle differences

Written by Peng Xi Feng
Ophthalmology
Updated on September 28, 2024
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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 Peng Xi Feng
Ophthalmology
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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.

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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 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 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.