GLAUCOMA which involves an increase in the intraocular pressure is one of the most serious problems in ophthalmology. This increase in pressure is generally due to a disturbance between the production and the absorption of the aqueous humor, although many factors enter into this. Since the normal pressure varies from 15 to 30 mm. of mercury anything higher is considered abnormal.
For convenience glaucoma is usually divided into several types:
Primary including (a) acute congestive, (b) chronic simple, and (c) absolute.
Congenital (buphthalmos and hydrophthalmos).
Sudden loss of sight, severe and excruciating pain, and possibly associated vomiting are characteristic for acute congestive glaucoma. Usually the patient is not aware of any prodromal signs, although these may be present, such as halos about lights and transient attacks of mild pain. One eye only is commonly involved although there is a tendency for the other eye to become affected later. Examination may reveal some edema of the eyelid and there is usually congestion of the bulbar conjunctiva. The cornea is steamy and the anterior chamber is almost obliterated. The pupil is mildly dilated and fixed. Usually the fundus cannot be seen. The intraocular pressure is elevated, often measuring as high as 80 to 90 mm. of mercury.
The patient is frequently in such pain that an examination is difficult, but vision may be reduced to light perception. Visual field changes usually cannot be obtained due to the severe pain from which the patient is suffering. Treatment consists of. . .