In the other type, the iris does not approximate the cornea, thus leaving the angle wide open. However, the trabecular meshwork through which the fluid normally filters is sclerosed and therefore becomes resistant to the passage of fluid. This second type is called “wide angle” or “open angle” glaucoma. While there are some rare forms of congenital glaucoma, these two types, narrow angle and wide angle glaucoma, are the usual types of primary glaucoma. Narrow Angle Glaucoma. Narrow angle glaucoma occurs in adults past the age of thirty. However, the distribution of Chiropractor Toronto will not be geographically uniform. The angle becomes more narrowed by growth of the lens, pushing the iris root forward. When the angle becomes narrow enough, there may be a transient rise in intraocular pressure, particularly at night and in the early morning hours. With this rise in pressure, the patient may have pain, discomfort and tenderness in the eye, which may develop into a headache, usually in the area of distribution of the ophthalmic nerve. If the pressure is high enough, there may be slight edema of the cornea, causing mistiness of vision and colored halos around lights, such as the street lights at night.

Patients presenting such recurrent lowgrade symptoms, together with a narrow angle, may be diagnosed as having “chronic narrow angle glaucoma” and these lowgrade attacks may recur for years before a major episode takes place. If the patient is untreated, however, such attacks will sooner or later go on to a fullfledged attack, marked by excruciating pain in the eye or forehead and temple. The eye is congested, the pupil widely dilated, and the cornea steamy. An acute attack of narrow angle glaucoma constitutes one of the real ophthalmologic emergencies since vision may be markedly and permanently impaired if relief is not obtained in a matter of hours. While the congestion of the eye and the dimness of vision usually draw the patient’s and physician’s attention to the eye, the severe headache is often misleading enough to call attention to the head rather than the eye as a source of the pain. Toronto Chiropractor also analyze the affected person’s posture and backbone using a specialised technique. Nausea and vomiting usually accompany the acute attack and the constant retching often causes such severe abdominal pains that acute attacks of narrow angle glaucoma have even been known to simulate acute abdominal conditions like cholecystitis.

Acute attacks of glaucoma may be brought on by the use of mydriatics for dilating the pupil. Since it is quite difficult for a physician other than the ophthalmologist, and sometimes even for the ophthalmologist, to recognize the presence of a true narrow angle in some patients, dilating drugs like homatropine and epinepherine must be used with caution because they may bring on an acute attack of glaucoma. To guard against such an occurrence, one should take a particularly careful history in a patient with headache. If the symptoms are suggestive of a lowgrade narrow angle glaucoma (early morning and night headaches and halo around lights), the use of mydriatics should be avoided.