There are many types of glaucoma, including congenital, primary, secondary, neovascular, and so on. The two main types of glaucoma that are relevant to most people are the open-angle and closed-angle types of primary glaucoma, so let’s briefly discuss these two types. The open-angle type occurs mainly in young people, in their twenties and thirties, and the symptoms are not obvious, but the consequences are very serious. Unknowingly, without pain, the visual function will be severely damaged, or even lost. Many patients go to the ophthalmology department for examination of other diseases and are unintentionally found to have glaucoma, and usually the unintentionally discovered glaucoma is more serious than the disease he purposely came to the ophthalmology department to be diagnosed and treated. What is glaucoma when it’s so scary? Simply put, there is a circulatory system inside the eye, with a faucet and a sewer. The faucet produces water, which produces fresh water that brings nutrients, and the sewer drains, which drains away metabolites. Flowing water does not decay. Once this circulatory system goes wrong, the balance within the eye is disturbed and something goes wrong. With glaucoma, the faucet is normal and the sewer is blocked. It’s like a balloon, only pumping air in, not out, the pressure is getting higher and higher, this balloon ends up bursting. The wall of the eye is actually very hard, will not easily burst, but the pressure is high, it will be like the high air pressure in the balloon, touching the Bang Bang hard, will top the eye swelling eye pain, headache nausea and vomiting. Many patients therefore consult a gastroenterologist, thinking it is a gastrointestinal disease, or a neurosurgeon, thinking it is a tumor in the brain. In fact, it is an eye problem. Normal intraocular pressure is 11-21 mmHg, beyond which there is a high suspicion of glaucoma (of course, there are some people who are not glaucomatous, although they are higher. There is variation in everything, and there are cases that are not within the normal range but are indeed normal. Just like many people over two meters are caused by tumors in the pituitary gland, but there are also many people, like Yao Ming, 2 meters 26, with no tumors in the pituitary gland). If you suspect glaucoma, you have to do further and more detailed tests to confirm the diagnosis, or not. Because if it is primary glaucoma and no treatment is done, then you can be very sure that the person will definitely end up with 100% blindness. There is no possibility of self-healing. After having the test, the diagnosis of glaucoma is not considered for the time being, but it is also necessary to follow up for a long time and closely observe the changes in IOP, fundus, visual field or OCT. Because there are also some people who have high IOP alone without any other abnormality and not identified as glaucoma, after years of observation later, they still end up, or evolve into glaucoma again. And once the diagnosis of glaucoma is confirmed? It needs to be treated very carefully and for a long time, not even a day. There are many ways to treat glaucoma, including eye drops, laser, and surgery. There are also countless surgical procedures. The only purpose of all the treatments is to lower the pressure in the eye and prevent the high pressure in the eye from causing the optic nerve to atrophy. Once the optic nerve has atrophied, it is extremely difficult, if not impossible, to recover with the current level of technological development around the world. The scary thing about open-angle glaucoma is that it can cause loss of visual function without knowing it. Didn’t you just say that high intraocular pressure can cause eye swelling and eye pain, and even headaches and nausea and vomiting? Yes, that’s what happens when the eye pressure is high enough. The open-angle glaucoma, annoying in that its eye pressure, usually higher than normal, but not too high, generally in the 20 to 30 or so, so you do not feel obvious, but also years and years of damage to the optic nerve, many people have reached an advanced stage, only to find their eyes bad. Some people will ask, even if the eye does not hurt, vision loss they can feel ah? But glaucoma causes optic nerve atrophy, visual impairment, and special in that it affects the visual field, which is the range of what a person’s eyes can see. Until the late stage of glaucoma, many people’s vision can still 1.0, but the visual field has been severely reduced, or even reduced to only the tubular field. In other words, he can only see as large as a tube rolled up with newspaper in front of him. A person who is not standing directly in front of him will be blind. The objects around him, pedestrians, cars, he could not see them. Life would be completely unmanageable. Therefore, the World Health Organization has long defined that, in addition to poor vision, even if the visual acuity is 1.0 and the field of vision is less than 5°, it is also a criterion for blindness. In addition to the open-angle type, the most common type of glaucoma is the closed-angle type. It usually occurs in the elderly. The clouding and swelling of the lens squeezes the iris that makes up the pupil, causing the atrial angle to close and indirectly causing a blockage of the drain, leading to glaucoma. In this type of patient, the intraocular pressure can be as high as 60 or more, and the symptoms are severe and painful to the point of being unbearable. Usually with closed-angle glaucoma, it is difficult to achieve long-term IOP control with medication alone. Even remission is difficult. Depending on the condition, laser or surgical treatment should be considered as soon as possible. A special type of glaucoma is normal pressure glaucoma. The eye pressure is within the normal range, but it is also glaucoma. The same optic nerve slowly atrophies and the visual field slowly shrinks. It is likely that for most people, an IOP of 11-21 mmHg, which does not cause pressure on the optic nerve, is still too high for them and needs to be lowered to be safe. This category of patients is more problematic to treat, and is limited by space and rarity, so I will not go into detail. The drugs used to treat glaucoma are usually divided into several categories, including mannitol, which is used to remove the excess water from the eye. The oral acetazolamide, as well as the eye point of thimerosol, Pyridamole, Alphagen, Meclizine, etc., are to inhibit the secretion of atrial fluid, that is, to turn the faucet small. Suvetan, Silyta, etc., are to promote atrial aqueous discharge, and are generally only suitable for the treatment of open-angle glaucoma.