This disease is a kind of syndrome characterized by the increase
in intraocular pressure. It can be classified into three main
types: primary, secondary and congenital. This section only
deals with the acute congestive glaucoma (angleclousure
glaucoma) of the primary type. Clinically, it is characterized
by acute increase in intraocular pressure, mixed congestion of
the eyeball, corneal edema, mydriasis, greenish-blue pupil
margin, accompanied with severe swelling of the eye, headache,
nausea and so on. It belongs to the category of "liufeng
neizhang" (green glacucoma) in TCM. When it comes into the
absolute stage, it belong to the category of "huangfeng
neizhang" (absolute glaucoma with cataract) in TCM.
Main
Points of Diagnosis
1. It is manifested as acute swelling of the eye,
headache, nausea, diminution of vision and so on.
2. There is mixed congestion of the eye, corneal edema with
misty opacity, opacity of aqueous humor. The anterior chamber
becomes shallow. The pupil becomes enlarged and loses its normal
circular contour, with the presence of green-blue reflection of
light inside the pupil.
3. The eyeball becomes as hard as stone. The intraocular
pressure usually comes up to more than 6 KPa, even exceeding 10
KPa.
4. If the persistent increase of the intraocular pressure fails
to come down, later on complete blindness results. If the
dilated pupil fails to constrict, if iris becomes discolored and
the crystalline lens becomes yellow or yellowish-white in color,
then it turns to the absolute glaucoma.
Differentiation and Treatment of Common Syndromes
1. Internal Treatment
1) The Type of Upward Attack of Wind-Phlegm
Main Symptoms and Signs: The eye becomes distended as if it were
to be broken up. The head aches badly as if it were splitting.
Other likely features are nausea, vomiting, mixed congestion of
the eyeball, misty corneal edema, the pupil getting dilated with
green colour and the eye becoming as hard as stone.
Therapeutic Principle: Removing heat from the blood and calming
pathogenic wind, resolving phlegm and improving vision.
Recipe: Decoction of Imperata Rhizome and Bamboo Juice
imperata rhizome
bamboo juice (divided into two equal quantities, with one
portion added to the decoction each time)
white peony root
scutellaria root
giant typhonium tuber
curcuma root
coptis root
phellodendron bark
wine-treated rhubarb
batryticated silkworm
powder of buffalo's horn (to be taken after being infused in
boiling water)
All the above ingredients except bamboo juice and powder of
buffalo's horn are to be decocted in water for oral
administration.
2. The Type of Lung-Deficiency and Liver-Asthenia
Main Symptoms and Signs: distention of the eye and headache
appear and become worse in the afternoon and in the evening.
There occurs slightly mixed congestion of the eyeball, with the
color light but dark. There appear milder corneal edema,
mydriasis. The pupil margin looks greenish-blue in color.
Intraocular pressure rises to about 6 KPa and severe diminution
of vision results.
Therapeutic Principle: Tonifying the lung and calming the liver.
Recipe: Modified Prescription of Mother Nourishing Powder.
ophiopogon root
asparagus root
red tangerine peel
poria
prepared pinellia tuber
sweet wormwood
trichosanthes root
licorice root,
wine-treated flavescent sophora root
gentian root
areca seed
dragon's bone
oyster shell
All the above ingredients are to be decocted in water for oral
administration.
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