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World Glaucoma Week 2017 #5 – March 16

Primary Open & Closed Angle Glaucomas

Info Card: You could have glaucoma and not know it. Make a resolution to find out. Schedule a dilated eye exam. Image of the US indicating 50% of the population knowing they have glaucoma and the other 50% who don't know.

Courtesy: National Eye Institute, National Institutes of Health (NEI/NIH).

Over the past few days, I’ve shared the Eye-Q Test, risk factors, what it looks like, and statistics on glaucoma. Today I want to focus on the two main types:

  1. Primary open-angle glaucoma
  2. Closed-angle glaucoma

Primary Open-Angle

There are several types of glaucoma and out of the two main types, primary open-angle is the most common. Speaking from personal experience even though my eye pressure was running anywhere from 30 to 40+ mm Hg this type of glaucoma progresses gradually, is totally painless, and there aren’t any other noticeable symptoms.

Like a clogged drain, in primary open-angle glaucoma, the eye doesn’t drain fluid as well as it should. Pressure builds and begins to damage the optic nerve. What I found interesting is there are people whose optic nerves are sensitive to normal eye pressure (12-22 mm Hg). This is why it’s so important to have regular eye exams to find early signs of damage to the optic nerve.

Closed-Angle Glaucoma

Angle-closure or narrow-angle glaucoma occurs when a person’s iris is very close to and can end up blocking the drainage angle in their eye. An acute attack happens when the drainage angle gets completely blocked causing eye pressure to rapidly rise. This is a medical emergency requiring immediate treatment to prevent optic nerve damage and potential blindness. Following are symptoms of acute-angle closure glaucoma*:

  • Sudden, severe pain within your eye and an ache around your eye.
  • Redness of your eye.
  • Blurred or reduced vision, often with circles (halos) seen around lights.
  • The pain may spread around your head and be felt as a severe headache.
  • Some people develop a feeling of sickness (nausea) and are sick (vomit).
  • Your eye usually feels hard and tender.
  • You may feel generally unwell.
  • The clear surface of your eye (your cornea) can look hazy.

30% or 1 out of 3 people with angle-closure glaucoma will have a sudden blockage causing an attack. However, in many people, this type of glaucoma called chronic angle-closure glaucoma develops slowly with no symptoms until there is severe damage or they have an attack.

*Source & Additional Information: Patient

22 thoughts on “World Glaucoma Week 2017 #5 – March 16”

  1. Thanks. And, I’m with you when it comes to throwing up. I’ll do everything I can to not do it. I don’t know if I told you or not, but I think the last time I did was about 17 years ago!

  2. Glad to hear your dad’s appointment went well. Hopefully these drops with him using a damp cloth will help.

    Ugh-throwing up??? I can’t do it just the thought of it makes my skin crawl although I did get that sick a couple of years ago but I feel like such a baby when I have to vomit. It wracks the entire body. I hope your episode has passed.

  3. They are back. Dad said the doctor said he has extremely dry eyes, even though he has been using artificial tears twice a day for a couple of months. The said he could see why his left one was hurting him. So, he gave him some different drops to use and told him to lay with a warm, damp cloth on his eyes when he got a chance. He has a follow up appointment in a little over a month. And, I am feeling some better. I haven’t thrown up since this morning, so hope that is over. I feel pretty good when I am sitting around, but have zero energy when I start walking around. I have been able to eat and keep down dry toast, chicken broth, and a baked potato. So, I am hoping this is something that will be gone tomorrow. I HATE throwing up and fortunately, don’t do it very often. The last time was probably 17 years ago!

  4. I woke up sick during the night, so am not able to take dad. Fortunately, one of our neighbors is taking them instead. I hope they can hear and understand what the doctor says. If not, I can always call them later. I would have to get sick last night, of all nights.

  5. You’re very welcome. Cataracts can have an extremely high impact on the quality of sight. When I had mine remove, even though the removal didn’t improve my vision, the fact that so much more light was able to come into my eyes made it seem like I could see better. There was a huge difference before removal vs. after. Yes please let us know how your dad makes out with his eye appt. I hope the doctor can give him a diagnosis, relieve the pain he’s feeling in his right eye and a favorable prognosis.

  6. Thanks for the info. I know that you/he is not providing any kind of diagnosis. That would be impossible without actually seeing my dad. It is good to know that glaucoma generally doesn’t cause fluctuations in vision. I have a feeling it is probably the cataract he has on his left eye causing the most problems. His right eye hurts, but that could be from overuse because his left eye is so bad. I appreciate you taking the time to get this information for me. I’ll let you know what we find out on Friday. BTW, he has been diagnosed with dry eye before.

  7. Here’s what George had to say. Please understand this is in no way a diagnosis rather just a little insight.

    “Pressure will fluctuate diurnally. It tends to be highest about 5 AM. That is why doctors try to schedule patients whose pressure is marginal early in the day.
    Acute glaucoma occurs when pressure gets very high. It is excruciatingly painful. Dilated pupils. Vomiting.
    Otherwise glaucoma doesn’t generally cause fluctuations in vision. Never say never; we are people, not diseases.
    The doctor might say Dry Eye, which is a misnomer because there are tears. The tears are not lubricating, so the actual surface of the eye is dry.
    Unstable diabetes.
    Cataract can appear different when lighting changes.
    He needs to see the doctor Friday.
    I hope this helps. I’m not making a diagnosis or offering advice beyond See the doctor!”

  8. mine are mainly from “fixed” myopia too. the amount depends on my pupil size as abig part of my pupil makes the old image, so thereʻs the giant halo from that. on a good day.

  9. Right, I had halos for years simply due to being nearsighted. It had nothing at all to do with glaucoma or anything else at the time because this was prior to sight loss and subsequent issues. Some of the material I was reading said that closed angle can be difficult to diagnose probably due to the symptoms being the cause of some many other issues.

  10. Maybe it’ll feel like kidney stones on the eyes?
    Unless there’s so,e more clues of what kind of pain to look for, it’ll be difficult to figure. Especially if all those other things are there already, halos and haze, various other kind of eye pain and varying amounts of usable sight…

  11. I don’t have any idea what a closed angle attack feels like but if it’s worse than uveitis, I don’t want to know. I have a friend who has closed angle glaucoma and when she had her attack she said the pain was unbelievable.

  12. I’m really not sure. Mine fluctuated from time to time but it never went back to normal without medication. I’ll see if i can get George from Popping Wheelies to answer as he is a former eye doctor.

  13. This may be a silly question, but, is it possible for the pressure to build up and then go down on it’s own periodically, causing blurred vision for short periods of time? I know the permanent damage is from optic nerve damage, but wonder if the pressure itself can cause temporary problems before the nerve is damaged. Hope that question makes sense. The reason I’m asking is that my dad is having some eye issues. He has an appointment this Friday. He says that one of his eyes hurts sometimes, pretty badly, and when he is reading or watching TV it gets blurry.

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