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Question: What’s the difference between open and closed-angle glaucoma?

Answer: Open-angle glaucoma, also called chronic glaucoma, is what the majority of glaucoma patients suffer from. In this condition, aqueous fluid does not drain well out of the eye. One theory is that the trabecular meshwork filter may have microscopic particles clogging it and slowing down fluid movement.

Closed angle glaucoma, also called acute glaucoma, is an ophthalmologic emergency. This occurs when the iris bows forward and completely blocks fluid access to the trabecular meshwork entirely. The pressure builds up in a positive feedback loop, the patient has excruciating eye pain, and vision is lost quickly.

If you want to use an analogy, think of the eye as a kitchen sink. In chronic open-angle glaucoma, there is debris in the pipes (rust, food, hair) that slows down drainage of fluid. We treat this by giving medications that work like drain-o. With acute glaucoma, there is a rubber stopper floating around in the bottom of the sink that suddenly blocks the drain. Water quickly rises and overflows the sink. We treat this by punching a hole in the rubber stopper (a laser iridotomy).



52 Comments



SOORY, IT NEED FURTHER ELABORATINS
THANK YOU.



Comment by gashaw — September 13, 2009



Wow! Thanks! It really helps to start with a cool analogy like that before you start going over the “elaborations” in the text book. Thanks again!



Comment by idrees — March 25, 2010



excellent explanation



Comment by wizzle — April 2, 2010



the answer that i’m scarching for



Comment by vaskar4u@gmail.com — June 30, 2010



Short and sweet. Perfect with the help of analogy, sufficient for people who never studied on this field to understand



Comment by Koei — July 14, 2010



Very nicely explained!



Comment by Manjunath — October 12, 2010



Thank you for this easy-to-understand explanation. I especially love the analogy. This is exactly what I need to under the very basic difference between the two. Thank you once again.

rhan



Comment by rhan — November 16, 2010



the kitchen e.g is fantastic ….it make me easier to understand the difference.. thanks



Comment by taimoor ali — December 8, 2010



kuul….Nice answer..



Comment by Mihi — March 23, 2011



A+++++++++++



Comment by mahia — April 7, 2011



love you all



Comment by mahia — April 7, 2011



this has helped me demystify the mystery that exists between these 2 entities – thank you so much -



Comment by pinky — April 12, 2011



Cheers, great answer !



Comment by Tom — April 15, 2011



Thank you very much for this simple but great information! I will always remember the difference now with that kitchen sink analogy!

Thanks



Comment by A stressed and confused medical student — June 4, 2011



excellent analogy of open and closed glaucoma.



Comment by babes sicam — August 5, 2011



Thank you very much for u r simple but poerful explanation.



Comment by Vamsi — August 24, 2011



its easy to understand with such daily life examples.. thanks!



Comment by Dr. P — September 21, 2011



Thank you great explanation



Comment by Sameh Bolos — November 6, 2011



Thanks for the wonderful explanation.
1. Does punctum have any role in glaucoma?



Comment by Anant V. Lakhotia — November 18, 2011



Could someone tell me if/how there is a way to tell them apart on fundoscopy images?



Comment by Anita Sholler — November 22, 2011



excellent analogy



Comment by Arshad — November 25, 2011



Great explanation, shortand sweet. Great analogy! Thanks!



Comment by Faria — March 21, 2012



simplest explaination



Comment by Muqaddas — June 25, 2012



Thanks so much. so well done.



Comment by rosemary — July 6, 2012



nicely explained..thanku so much



Comment by bwalya — July 23, 2012



very fudu answer



Comment by hitesh — August 11, 2012



nice explanation



Comment by dr.raj — August 21, 2012



elaborate a little more.plz



Comment by dr.amin — October 20, 2012



VERY WELL EXPLAINED! JUS TO FURTHER ELABORATE,GLAUCOMA CAN BE CAUSED BY EITHER:
1)OVER PRODUCTION OF AQUEOUS HUMOUR IN THE EYE OR;
2)UNDER DRAINAGE OF THE AQUEOUS HUMOUR
AND CAN BE TREATED WITH EITHER PERIPHERAL OR LASER IRIDOTOMY SURGERY; OR THE FFG. DRUGS IF CHRONIC:

1) ACETAZOLAMIDE- carbonic anhydrase inhbitor; that prevents the production of carbonic acid which inturn prevents leakage of sodium ions into the eye were the vitrous humour is produced.

2)HYPEROSMOTIC AGENTS-EG. MANNITOL

3) MIOTIC AGENTS-eg.PILOCARPINE 2%- That cause miosis(pupil constriction) in order to pull the iris from the trebecular meshwork.

4) ANALGESICS -for the associated pain the patients experiance

5)ANTIEMETICS – for the associated nausea and vomitting (if present)

and note that PILOCARPINE 2% Can be used as a prophylactic agent (ie. to prevent furher damage of glaucoma if the patient is scheduled for surgery…

hope this helps from a pharmaceutical perspective! :)
NELOSHINI.NAICKER
B.Pharm



Comment by NELOSHINI.NAICKER-B.Pharm — November 4, 2012



Excellent. Dr had to punch “my stopper” 13 times on rt eye and 3 times on the left!



Comment by Kennedy — November 15, 2012



couldnt be explained any better,thank you so much



Comment by canberk — November 19, 2012



thank you for that very clear explanation of open vs closed angle glaucoma.



Comment by gwendolyn jordan — December 4, 2012



Hitting da nail at the head Bravo



Comment by Dr Oranuka — February 24, 2013



Thank you for explaining the difference. I didn’t realize there were different types. Your illustration was very helpful as well.



Comment by joanne — March 13, 2013



Succinct!!!



Comment by Colza — March 19, 2013



thanx it is to understand



Comment by anwaar aslam — March 22, 2013



easy to understand for mbbs students



Comment by anwaar aslam — March 22, 2013



excellent explanation



Comment by Zagy — April 28, 2013



I celebrate u all hw can Stoke cause diplopia? How can it be look in to? Please waiting for answer.



Comment by Dr.further explanation on what causes dilopia. — June 4, 2013



thank you



Comment by terry — August 15, 2013



thumbs UP



Comment by hussein — September 25, 2013



Very easily explained even a layman can understand



Comment by Saxena — November 10, 2013



Very good example used,to understand.



Comment by Ravi — November 14, 2013



so is there an increase in IOP in open angle glaucoma? from what i read they both have an increase. so what about the pressures that differentiate them so distinctively?
Next question: Is Beta Blocker the first line treatment for open angle glaucoma?



Comment by Roxie — December 5, 2013



Roxie:
1. Yes, there is generally an increase in eye pressure for ALL types of glaucoma. People in acute glaucoma often present with eye pressures of 40-70 (i.e. dangerously high) and have severe eye pain because of this. Open-angle glaucoma pressures are usually in the 20-35 range and asymptomatic.

2. Beta-blockers are a fine first-line treatment for open-angle glaucoma. Many eye doctors, like myself, start with prostaglandins (latanaprost) as our first line agent given how effective they are and the minimal systemic side-effects.



Comment by Timothy Root, M.D. — December 6, 2013



That really helps a great deal. Thank you.



Comment by HerMajestytheQueen — January 11, 2014



I am repeating the compliments of previous responders, the analogy given is excellent and easy to understand, I am happy no medical jargon used to confuse the patient. The MD who ansered the question and practices in Houston I will go to him for eye check up.



Comment by jamil azzam — April 2, 2014



Great analogy. I worked for many years in the hospital doing laser procedures, like iridotomies and trabeculoplasties.
This is a great explanation. Wish I could have explained it to the patients like that.



Comment by Mary Rohn — April 25, 2014



EXCELLENT……..



Comment by Dr Ravi Krishna — May 6, 2014



best way of explanation



Comment by dr k k goyal — September 30, 2014



I just had the iridotomy done on my right eye! It was not painful at all. Going for check up tomorrow and then the doctor will do the left eye! I had no symptoms or pain in my eyes! I went for routine check up to my optometrist and she referred me to ophthalmologist! I am glad she did!



Comment by Libor — September 30, 2014



good



Comment by RENU — October 5, 2014




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