Glaucoma is essentially an increase in the intra-ocular pressure. All
other symptoms of the trouble may be traced to this condition.
In =Primary Glaucoma= the increase in pressure sets in without any
discoverable antecedent disease of the eye.
In =Secondary Glaucoma= the increase in pressure is due to some other
disease of the eye. It is a symptom, a complication or accessory and is
confined to the eye diseased.
Primary glaucoma affects both eyes, but not always at the same time.
Fuchs says primary glaucoma constitutes about 1% of all eye diseases.
It is often mistaken for iritis or iridocyclitis and treated with
atropine which is contraindicated. It may be regarded as beginning
cataract and time lost in expecting it to become ripe. These delays and
wrong treatment have caused much blindness.
Palpation with the finger or the use of the tonometer may readily
detect any increase in tension. A correct diagnosis must be made early
and proper treatment instituted if vision is to be saved.
=Primary glaucoma= may or may not have signs of inflammation. If the
tension rises suddenly inflammatory symptoms develop (acute) while if
the increase in tension develops gradually these symptoms are lacking
(simple).
=Acute primary glaucoma—Symptoms.=—First stage, rise in tension, vision
obscured, sees a colored ring around lights, cornea dull, pupil dilated
and sluggish, some ciliary injection. The attack may clear up for a day
or for weeks. Gradually the symptoms become permanent after repeated
attacks. Second stage, when the attack comes there is much pain, visual
power fails rapidly, may be edema of the lids and chemosis of the
conjunctiva, all symptoms become much exaggerated, the cornea becomes
cloudy. After a violent attack the vision is more or less permanently
damaged. Third stage, after many attacks the optic nerve becomes
excavated and atrophy takes place.