FUNDAMENTAL CONCEPTS IN GLAUCOMA

Abstract

THE CONVENTIONAL classification of primary glaucoma which has long been accepted involves a division of its clinical mainfestations into two types—simple (or noncongestive) glaucoma and congestive glaucoma. As a general rule the first type develops slowly, quietly and insidiously over many years with a characteristic triad of symptoms—raised tension, typical field defects and cupping of the disk—until in the "absolute" stage the eye becomes intensely hard, all vision is lost and the disk develops a deep, atrophic cup. The second type, on the other hand, is generally characterized by episodic subacute attacks of raised tension, the most notable features of which are the diminution of vision and halos caused by corneal edema; from the less severe of these episodes the eye may seem to recover to a considerable extent, but subsequent attacks tend to involve a permanent raising of the tension (chronic congestive glaucoma) or an acute attack may