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 Wang Hui Zhen
Ophthalmology
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Early symptoms of glaucoma

There are many types of glaucoma, and the symptoms vary between different types. Some patients with glaucoma might not have noticeable symptoms in the early stages; others may only experience mild eye soreness and occasional blurred vision, which can improve with rest; some present with insidious vision decline and field defects. Glaucoma refers to a group of progressive optic nerve damage that eventually impairs vision, mainly associated with pathological elevation of intraocular pressure. Glaucoma is the second leading cause of blindness worldwide, and it is the top irreversible blinding eye disease. Common symptoms of glaucoma include blurry vision, vision decline, field defects, and acute attacks, often accompanied by eye pain, headache, nausea, vomiting, and more. If glaucoma symptoms occur, or there is a suspicion of glaucoma, it is advised to visit an ophthalmology clinic for comprehensive examinations like visual acuity, intraocular pressure, fundus examinations, etc., to determine the cause and provide targeted treatment, actively reduce intraocular pressure, and protect the optic nerve.

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Written by Zheng Xin
Ophthalmology
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Must glaucoma undergo surgery?

Glaucoma is a group of diseases characterized by pathological increase in intraocular pressure that causes damage to the optic nerve and visual field defects. The treatment for glaucoma can include conservative management and surgical interventions. The primary goal of treatment is to control intraocular pressure and delay the progression of optic nerve damage. Generally, intraocular pressure can be controlled with medication; if medication fails to control the pressure, surgery may be necessary to manage it.

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Written by Zheng Xin
Ophthalmology
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What to do with high eye pressure glaucoma?

Glaucoma is a group of eye diseases characterized by typical optic nerve atrophy and visual field defects. Its main features are high intraocular pressure and visual field damage. The treatment of glaucoma primarily focuses on controlling intraocular pressure, delaying damage to the optic nerve, and preserving remaining vision. Lowering intraocular pressure is essential for treating glaucoma, so it can be treated locally with medications that reduce intraocular pressure. If medications cannot control the pressure, surgery may be necessary to manage it. (Specific medications should be used under the guidance of a physician.)

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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 Zheng Xin
Ophthalmology
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Is high intraocular pressure always glaucoma?

Glaucoma is a group of eye diseases characterized by typical optic nerve atrophy and visual field defects, with high intraocular pressure and visual field loss as features. Clinically, some patients have long-term high intraocular pressure but do not exhibit optic nerve and visual field damage. This condition is not called glaucoma, but is referred to as ocular hypertension. Meanwhile, some patients may have normal eye pressure but still exhibit typical glaucoma optic nerve damage and visual field defects; this condition is called normal-tension glaucoma. Therefore, high intraocular pressure does not necessarily indicate glaucoma, and normal intraocular pressure can also potentially be glaucoma.