Does glaucoma require surgery?

Written by Zheng Xin
Ophthalmology
Updated on August 31, 2024
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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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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.

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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.

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Written by Peng Xi Feng
Ophthalmology
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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 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 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.