How to rule out glaucoma with high eye pressure?

Written by Li Zhen Dong
Ophthalmology
Updated on September 19, 2024
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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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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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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 Zheng Xin
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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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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.

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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.