Glaucoma

Glaucoma is a chronic eye disease causing high intraocular pressure, either periodic or constant, atrophy of the optic nerve (glaucomatose excavation), and changes in the visual field. Glaucomas can be primary, secondary, or congenital.

Impairment of vision

It impairs the circulation of aqueous moisture and causes heightened intraocular tension. Subsequent trophic changes in the eye tissues cause high intraocular pressure. Vision impairment occurs due to the atrophy of the retina and optic nerve functional elements. The disease is typical of people older than 40. In the case of secondary glaucoma, changes in the intraocular liquid outflow tracts result in heightened intraocular tension.

In the case of congenital glaucoma, high intraocular pressure mainly arises from impaired intraocular liquid outflow because the mesoderm tissue blocks the angle of the forward chamber. There are two basic forms of primary glaucoma: open-angle and closed-angle. Disease development is usually latent and hidden for the patient.

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Cases

Patients, as a rule, have no subjective sensations. However, in some instances, they may complain of fullness in the eyes, headaches, misting of vision and iridisation. Visual changes in the eye are scarce. An examination may reveal the expansion of the forward ciliary arteries (the cobra symptom). Besides, biomicroscopy may show dystrophy of the retina and solution of the eye pigmentary edge continuity. Gonioscopy also exhibits that the angle is open.

Closed-angle glaucoma

In the case of closed-angle glaucoma, patients complain of pain in the eye and headaches, misting of vision, iridisation and stagnation in the forward eye segment. The disease begins with an acute or subacute attack.

The cornea is hydropic; the chamber is small; the pupil is mydriatic. The iris may also be hydropic. Besides, synechias and goniosynechias may form. Gonioscopy exhibits that the angle is completely closed.

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