Is high intraocular pressure always glaucoma?

Written by Zheng Xin
Ophthalmology
Updated on September 24, 2024
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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.

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Written by Peng Xi Feng
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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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What are the symptoms of glaucoma?

Glaucoma is a group of eye diseases characterized by characteristic optic nerve atrophy and visual field defects, with pathological elevated intraocular pressure as its main risk factor. The main symptoms of glaucoma include blurry vision and blocked vision. Due to different types, it is also accompanied by other eye symptoms such as eye pain, eye bulging, foggy vision, as well as pain in the nasal root and head, and even nausea and vomiting.

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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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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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How to deal with vomiting in glaucoma?

Nausea and vomiting caused by glaucoma should be actively treated with pressure reduction. Antihypertensive eye drops include Timolol eye drops, Brinzolamide eye drops, and Pilocarpine eye drops. If the effect is not satisfactory, oral administration can also be considered. Common oral medications include Acetazolamide, and systemic use of Mannitol. If necessary, anterior chamber paracentesis can be performed. This series of active treatments can completely control intraocular pressure and relieve symptoms. Eye symptoms mainly include redness, swelling, pain, foreign body sensation, burning sensation, vision decline, headache, nausea, and vomiting. (Please follow the doctor's orders when using medication.)