Lens glaucoma

Introduction Lens glaucoma is one of the symptoms of primary acute angle-closure glaucoma.

Cause

The basic cause and the anatomy of the anterior segment of the eye are particularly related to the state of the anterior chamber. Additional emotions, long-term work in the dark environment and close reading, climate change, and seasonal changes may lead to its acute onset.

an examination

Related inspection

Glaucoma priming test anterior chamber axial examination tonometry optometry visual acuity vision

Symptom description and clinical manifestations:

The axial length of the eye is shorter, the crystal is thicker, the relative position is earlier, and the anterior chamber is shallower. The pupil pressure is delayed and the pressure of the room is increased. The surrounding iris is pushed forward to block the corner of the room, causing the drainage of the aqueous water to be blocked and the intraocular pressure to rise.

Clinical phase six:

(1) Preclinical stage

1 The disease occurs at one glance, and the other eye is narrow.

2 There is a family history of the disease, and the test is positive.

(2) Precursor period

1 has a rainbow of vision, fog and eye pain, after sleep or adequate rest can be resolved.

2 mild ciliary congestion, the anterior chamber is slightly shallow, the pupil is slightly larger, and the intraocular pressure is slightly elevated.

3 or more symptoms are often associated with mood swings, fatigue, anxiety, insomnia, or climate change.

(3) Acute attack

1 visual acuity decreased sharply, accompanied by severe headache, eye pain, nausea, vomiting.

2 eye mixed hyperemia, corneal edema, pupil vertical elliptical dilated, severe conjunctival and orbital edema.

3 The anterior chamber is very shallow, the surrounding iris and the cornea are almost in the same area, and the angle is blocked.

4 intraocular pressure increased significantly, generally above 5.32kpa (40mmhg), severely up to 13.30kpa (100mmhg).

5 iris atrophy or posterior adhesion, peripheral iris adhesion, aqueous humor, pupillary anterior capsule crystal milky white opacity (glaucoma).

(4) Intermittent period (remission period)

1 There is a history of acute attacks, the symptoms disappear, the vision is restored to varying degrees, the congestion is reduced, and the corneal edema subsides.

2 Most of the anterior chamber angles are open, and the fluency coefficient of aqueous humor is often within the normal range. The intraocular pressure is normal after 48 hours of anti-glaucoma medication is stopped.

3 Most cases have segmental atrophy of the iris, post-corneal hyperpigmentation and lens glaucoma.

(5) chronic phase

1 The intraocular pressure continued to increase moderately after repeated acute attacks.

2 The anterior chamber angle is closed at 1/2 or more, and the c value is 0.10 or more.

3 The cornea is transparent, the eyes are not obviously congested, and the pupils are scattered.

4 vision loss, glaucoma visual field defect, optic disc glaucoma cup-shaped depression.

(6) Absolute period

The intraocular pressure continues to rise and the visual function is completely lost.

Differential diagnosis

Swollen lens cortical granules in the anterior chamber: lenticular glaucoma: a history of cataract surgery or a deep anterior chamber with a crystalline in vitro injury, the anterior chamber is still open at the time of onset, and the aqueous humor is evident. The anterior chamber contains a large amount of swelling. And contains a small amount of large macrophages and small white blood cells?, visible anterior adhesion around the iris.

Lattice iron deposition: Iron is the most common intraocular foreign body. Foreign matter in the crystal can form a localized cataract. If the iron foreign body is small, it can exist in the crystal for many years without obvious reaction, and iron can be oxidized in the eye. And gradually spread in the eye, forming eye rust, including the cornea, iris, lens, retinal rust, eventually leading to blindness, the rust of the eye is related to the size and position of the foreign body in the eye, the larger and the back of the eye Iron foreign bodies are easy to move to the back of the eye. There are small brownish yellow spots under the anterior capsule of the initial crystal, and there are brown rust spots under the anterior capsule in the late stage. The initial stage must be enlarged after the pupil is enlarged. The late stage crystal fiber degeneration gradually develops into an all white cataract, and finally the crystal is curled, or Due to the degeneration of the suspensory ligament, the cataract occurs because of the cataract caused by the absorption of iron by the epithelial cells, and the growth of new fibers is blocked. At this time, even if the cataract is removed, the visual acuity cannot be recovered quickly. Lens rust is a clinical symptom of traumatic cataract. Direct or indirect mechanical damage acts on the lens, causing a change in turbidity called a traumatic cataract. Patients are more common in children, young men and soldiers. There are three common types of cataracts caused by blunt contusions, blast injuries, and eye penetrating injuries. Due to the different factors of injury and local performance, the disease has a variety of names. Most cases can be described as a history of traumatic trauma, but traumatic cataracts that deny the history of trauma must not be ignored, especially in infants and young children.

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