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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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