Primary Open-Angle Glaucoma
Primary open-angle glaucoma (POAG), also known as chronic simple glaucoma, is a chronic, progressive optic neuropathy. Pathologically elevated intraocular pressure is an important factor contributing to optic nerve damage. Clinical features include progressive visual field narrowing and vision loss, accompanied by characteristic optic disc cupping and optic atrophy. It occurs mainly in middle-aged and older adults over 40. In its early stages, the disease often causes no symptoms, or may cause mild eye fullness, visual fatigue, or headache that improves with rest or sleep. As a result, it may go unnoticed early, delaying diagnosis and treatment. Some patients seek care only after one eye has become blind or the visual field has narrowed to a tubular field. Delayed treatment may lead to severe visual field loss in both eyes, reduced vision, and eventually complete loss of sight. In traditional Chinese medicine (TCM), this condition falls within the categories of “Qing Feng Nei Zhang” and “Qing Feng.”
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical Description:
Both eyes may be affected, either sequentially or at the same time. Eye fullness and headache, blurred vision, elevated intraocular pressure, and narrowing of the visual field; irritability or low mood, distension and fullness in the chest and flanks, restlessness and irritability; red tongue, thin coating, wiry pulse.
In Plain Language:
- Both eyes may be affected one after the other or at the same time, with a feeling of eye fullness and headache.
- Vision may become blurred or unclear.
- Intraocular pressure is elevated, with higher readings on examination.
- The visual field gradually becomes smaller.
- Irritability or low mood may occur.
- There may be a feeling of fullness or tightness in the chest and flanks, and restlessness.
- The tongue may appear red, with a relatively thin coating.
- The pulse may feel wiry (like a taut string).
|Treatment Approach
Clinical Description:
Promote Qi circulation and soothe the Liver.
In Plain Language:
- Encourage the smooth flow of stagnant Qi and ease distension or pain in the chest and flanks, frequent sighing, and feelings of emotional constraint.
- Ease feelings of tension and blockage, and reduce abdominal bloating, belching, poor appetite, and discomfort from fullness.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical Description:
Elevated intraocular pressure, dizziness and eye fullness; chest tightness, nausea, poor appetite; pale or red tongue, greasy coating, slippery or rapid-slippery pulse.
In Plain Language:
- Elevated intraocular pressure, dizziness, and an uncomfortable feeling of fullness in the eyes.
- Chest tightness, nausea, and reduced appetite.
- The tongue may appear pale or red.
- The tongue coating may appear greasy (thick and sticky, with an unclean-looking surface).
- The pulse may feel slippery, or slippery and relatively rapid.
|Treatment Approach
Clinical Description:
Promote urination and transform phlegm; harmonize the Stomach and direct rebellious Qi downward.
In Plain Language:
- Promote fluid elimination and address dampness and thick phlegm, with the aim of easing chest tightness, cough, and excessive thick, sticky sputum that is difficult to expectorate.
- Harmonize the Spleen and Stomach and direct Qi downward, with the aim of easing nausea, vomiting, belching, acid reflux, bloating, and poor appetite.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical Description:
With longstanding illness, the pupils gradually become dilated; vision is unclear and the visual field narrows; the eyeballs feel full and firm, and the optic discs appear pale. May be accompanied by fatigue, dizziness, tinnitus, soreness and weakness of the lower back and knees, a pale tongue with a thin coating, and a deep, thready, weak pulse; or a pale complexion, cool hands and feet, shortness of breath and fatigue, a pale tongue with a white coating, and a deep, thready pulse.
In Plain Language:
- As the condition persists, the pupils may gradually become dilated.
- Vision may be unclear, and the field of vision may gradually narrow.
- The eyeballs may feel full and unusually firm, especially on palpation.
- The optic discs may appear pale (visible on examination).
- Fatigue, dizziness, tinnitus, and soreness or weakness in the lower back and knees may also occur.
- The tongue may appear pale, with a relatively thin coating.
- The pulse may feel deep and thready, and lack strength.
- Alternatively, there may be a pale, lusterless complexion, cool hands and feet, shortness of breath, and fatigue.
- The tongue may appear pale with a white coating.
- The pulse may feel deep and thready.
|Treatment Approach
Clinical Description:
Nourish and tonify the Liver and Kidneys.
In Plain Language:
- Support the body’s nourishment and energy, with the aim of easing soreness and weakness in the lower back and knees, dizziness, tinnitus, and fatigue or weakness.
- Support strength and vitality, and reduce night sweats, sensitivity to cold, and declining stamina.
- Address blurred vision, eye dryness, and unsettled sleep, with the aim of promoting a more stable mood and general condition.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical Description:
Elevated intraocular pressure, dizziness, headache, and eye fullness; chest pain, hand numbness, insomnia, and forgetfulness; dark purple tongue with petechiae or ecchymoses, dark purple and distended sublingual veins, choppy or wiry-thready pulse.
In Plain Language:
- Elevated intraocular pressure, dizziness, headache, and discomfort from eye fullness or pain.
- Chest pain and numbness or tingling in the hands.
- Poor sleep or insomnia, and increased forgetfulness.
- The tongue may appear dark purple, with petechiae or ecchymoses (described in TCM as signs of impaired blood flow).
- The sublingual veins may appear dark purple and distended, with a tortuous appearance (described in TCM as indicating blood stasis).
- The pulse may feel choppy or wiry and thready.
|Treatment Approach
Clinical Description:
Invigorate blood and resolve stasis, promote urination, and open the orifices.
In Plain Language:
- Promote blood flow and address stagnation, with the aim of easing distending or stabbing pain and purplish discoloration.
- Promote the elimination of excess fluid to reduce swelling and dampness, and support a feeling of mental clarity and clearer vision and hearing.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.
References
- Jin Ming, Jie Chuanhong, Liu Jing, et al. Annotations to the TCM Clinical Diagnosis and Treatment Guidelines: Ophthalmic Diseases [M]. Beijing: China Press of Traditional Chinese Medicine, 2015: 70-78.
- Liu Jiaqi, Li Fengming. Practical Ophthalmology [M]. Beijing: People’s Medical Publishing House, 1984: 341-408.
- Li Fengming. Chinese Ophthalmology [M]. 2nd ed. Beijing: People’s Medical Publishing House, 2005(2): 1129-1169.
- Deng Shuyuan, Du Zhishan, Yang Wanqi. Clinical observation of modified Bazhen Tang combined with Wu Ling San for delayed formation of the anterior chamber after filtering surgery for glaucoma [J]. Chinese Journal of Ophthalmology of Traditional Chinese Medicine, 1995, 5(1): 32.
- Ji Zujie. Five cases of glaucoma treated with compound Wu Ling San [J]. Journal of Integrated Chinese and Western Medicine, 1984(4): 242.
- Li Xiang, Wen Xiaoxia, Wang Wanjie, et al. Combined treatment with Qi Ju Di Huang Wan, compound Danshen tablets, and mecobalamin tablets for glaucoma after intraocular pressure control, and effects on visual acuity and visual fields [J]. Shanxi Journal of Traditional Chinese Medicine, 2010, 31(4): 455-456.
- He Huiqin. A brief discussion of the ophthalmic applications of Wu Ling San [J]. Heilongjiang Journal of Traditional Chinese Medicine, 1999(6): 32.
- Yang Xinghua. Application of Wu Ling San during the perioperative period in ophthalmology [J]. Journal of Liaoning University of Traditional Chinese Medicine, 2009, 11(9): 29-30.
- Cheng Zhuzhen, Liu Xiufeng. Clinical observation of modified Xiao Yao San combined with Wu Ling San for delayed formation of the anterior chamber after glaucoma surgery [J]. Shanxi Clinical Medical Journal, 1997, 6(5): 327-328.
- Liu Jian, Zhang Lixia, Liu Jie, et al. Clinical observation of Yi Jing Qi Ju Di Huang granules for optic nerve protection in early-stage glaucoma [J]. Chinese Journal of Ophthalmology of Traditional Chinese Medicine, 2015, 24(4): 286-288.
- Tao Rongsan, Yang Xiaoyuan, Zhou Xinxin, et al. Observation of the clinical effects of integrated Chinese and Western medicine in 40 cases of advanced glaucoma with tubular visual fields [J]. Henan Journal of Traditional Chinese Medicine, 2010, 30(10): 1004-1005.