Taipei City Government

A female patient, who was approaching 75 years of age, visited the ophthalmologist due to blurred vision. She was found to be suffering from a high intraocular pressure of 35 mmHg, and was diagnosed with cataract and chronic angle-closure glaucoma. According to Dr. Chen Zi-Yi of the Ophthalmology Department at Zhongxing Branch of Taipei City Hospital, the three main types of glaucoma are: open-angle, angle-closure and congenital glaucoma. As the causes of the different types of glaucoma differ, they should hence be treated differently.
Angle-closure glaucoma is more common among Asians, mainly because of the narrower space between their cornea and iris (shallow anterior chamber), which is unfavorable for the normal discharge of aqueous humor. This causes intraocular pressure to increase, oppressing the optic nerve and causing it to shrink. This type of glaucoma, clinically known as acute angle-closure glaucoma, normally comes in the form of acute attacks, especially in dim environments or during the night.
Dr. Chen expressed that during an acute attack, the patient will encounter blurred vision, redness and pain in the eyes, nausea and see a rainbow halo around lights. With early treatment, intraocular pressure can be controlled and stabilized. If intraocular pressure remains high after laser or laser with medication treatment, then surgery has to be considered. Angle-closure glaucoma could also be in intermittent or asymptomatic chronic forms. In short, the most common treatments for angle-closure glaucoma are laser or laser with medication. If intraocular pressure cannot be controlled and stabilized, and the optic nerve continues to deteriorate, then the patient has to undergo surgery.
Many patients with suspected angle-closure glaucoma were safe with regular follow-ups during the initial stage. As age increases, cataracts are formed, and the thickened crystal structure will cause the already narrow angle to become even worse. As one reaches old age, it will eventually lead to intermittent angle-closure glaucoma or chronic glaucoma.
Dr. Chen reminds the public that regular checkups are required for all types of glaucoma to avoid deterioration without being aware. With routine checkup, the disease can be detected and treated early to ensure good visual quality.