Should the pupil be dilated or constricted in glaucoma?

In general, the choice between pupil dilation and constriction in glaucoma treatment is not fixed, but determined according to the patient's specific condition. Most cases of glaucoma require pupillary constriction; however, in cases of malignant glaucoma, pupillary dilation is needed for treatment. Patients are advised to promptly seek medical care at a hospital and follow their doctor's instructions. The detailed analysis is as follows:

Under normal circumstances, glaucoma treatment requires pupillary constriction. This is because constricting the pupil helps pull the iris tissue, preventing it from piling up at the angle of the anterior chamber, avoiding angle closure, ensuring proper drainage of aqueous humor, thereby reducing intraocular pressure and minimizing damage and stress to the optic nerve.

In rare cases, such as malignant glaucoma, treatment requires pupillary dilation. Malignant glaucoma is caused by ciliary blockage (ciliary body ring obstruction), and dilation of the pupil can help relieve this blockage, thus improving the condition. However, pupil dilation may lead to elevated intraocular pressure; therefore, this approach must be used cautiously, with close monitoring of intraocular pressure changes.

Therefore, when treating glaucoma, an appropriate therapeutic strategy should be selected based on the individual patient’s specific condition. In daily life, patients should take proper warming measures to avoid catching a cold, ensure adequate rest, and avoid excessive fatigue. It is also important to maintain a positive mental state, avoid emotional excitement, follow a light diet, and refrain from consuming spicy or irritating foods.