Severe acute angle-closure glaucoma can cause lens changes, with translucent porcelain or milky white cloudy spots visible under the anterior capsule of the lens in the pupil area, which some describe as glaucoma spots. How are glaucoma spots diagnosed? Early in the course of the disease, it may appear as a large patch. As the IOP decreases, this patchy clouding may appear partially retransparent, resulting in a punctate, flocculent, or hemispheric shape. The typical variation is an oblong or punctate clouding, located at the end of the lens fibers. It tends to be distributed along the lens fiber sutures and is therefore often radiolucent. In some milder lesions, only a few scattered dots appear in an irregular arrangement. The occurrence of glaucomatous spots is thought to be the result of a nutritional disorder caused by high intraocular pressure. With increasing age, glaucomatous spots can be pushed deeper by the hyaline cortex. These spots are clouded without appearing in the posterior lens cortex and in front of the lens obscured by the iris. Glaucoma spots are valuable for the diagnosis of acute angle-closure glaucoma, especially retrospectively. 1. Acute iridocyclitis and acute conjunctivitis The differential diagnosis has been described in general textbooks and is relatively easy, but it is important to emphasize that there are conflicting aspects in the treatment of these 3 diseases. Therefore, a wrong diagnosis will lead to deterioration of the disease and even cause the possibility of blindness. 2. Malignant glaucoma Since the clinical manifestations and ocular anatomical signs of primary malignant glaucoma and this disease have many similar aspects, it is easy to cause misdiagnosis. In addition, the differential diagnosis of the two diseases is very important because the principles of management are different and because misdiagnosis can cause serious damage. Malignant glaucoma is also characterized by narrowing of the anterior segment, but often the anterior segment is narrower, the lens is thicker, the eye axis is shorter, and the lens is more anteriorly positioned compared to this disease. Unlike this disease, the anterior chamber is shallow and the iris shows a consistent forward elevation in front of the lens, and most importantly, the condition worsens when treated with pupil reduction agents. This disease belongs to a category of glaucoma in which certain physical, mental and environmental factors cause acute closure of the atrial angle in sensitive individuals, which in turn leads to an increase in intraocular pressure, so psychological adjustment is important in prevention.