This is accompanied by pain and marked blurring of vision. In the more common chronic simple (or open-angle) glaucoma, the pressure increases gradually, usually without producing pain, and the visual loss is insidious. The same type of visual loss may rarely occur in eyes with a normal pressure: this is called low-tension glaucoma. Primary glaucoma occurs increasingly with age and is an important cause of blindness. Secondary glaucoma may occur when some other eye disease impairs the normal circulation of the aqueous fluid and causes the pressure inside the eye to rise.

In all types of glaucoma treatment is focused on reducing the pressure inside the eye. Drops are instilled into the eye at regular intervals to improve the outflow of aqueous fluid from the eye and/or to reduce the production of aqueous fluid. Drugs used include some beta blockers; miotics, such as pilocarpine and carbachol; adrenaline and drugs with similar effects to adrenaline; the sympathomimetic drugs apraclonidine and brimonidine; and the prostaglandin analogue latanoprost. Carbonic anhydrase inhibitors, in the form of tablets or eye drops, are also used.

A variety of drugs is available for the treatment of migraine attacks. Analgesics, for pain relief, usually contain aspirin, paracetamol, and/or codeine; if these are ineffective, tolfenamic acid (an NSAID) maybe tried. For people who fail to respond to these analgesics, 5HT1 agonists, such as sumatriptan or zolmitriptan, are the recommended treatment for an acute attack. They act by reversing the overdilatation
of the blood vessels in the brain. Ergotamine tartrate also constricts blood vessels, but it is less selective in this action than the 5131 agonists and has more severe side effects. Antiemetics, such as metoclopramide, cyclizine, or buclizine hydrochloride, may be required to relieve the nausea and vomiting associated with a migraine headache. These may be used alone or combined with an analgesic.

For people who experience frequent migraine attacks (more than one a month), a preventive approach is needed. The drugs used for this purpose include beta blockers (such as propranolol, metoprolol, nadolol, and timolol), the antihistamines pizotifen and cyproheptadine (which antagonize the effects of serotonin), and tricyclic antidepressants (such as amitriptyline). Since long-term treatment with these drugs is not advisable, the patient’s condition should be assessed at six-monthly intervals to see if treatment needs to be continued.
Some individuals benefit from the herbal remedy feverfew.

Obesity is the most common nutritional disorder of Western societies and predisposes to many health problems, including heart disease and diabetes. The main treatment is dietary restriction; drug treatment (if considered necessary) should only be used in conjunction with a carefully controlled diet.
Anti-obesity drugs that act on the digestive tract include orlistat and methylcellulose; phentermine acts on the brain to suppress appetite and should only be used on selected patients for short periods.

People affected with insulin-dependent (or type I) diabetes mellitus have little or no ability to produce the hormone and depend on daily injections of insulin. This type of diabetes can also be referred to as juvenile-onset diabetes because it usually starts during childhood or adolescence. The dosage of insulin must be carefully controlled and matched to the dietary intake of glucose. If cells receive insufficient glucose, fats may be used as an alternative source of energy, which can lead to alteration of the acidity of the blood, the accumulation of ketones (formed when fats are metabolized) in the bloodstream (ketoacidosis), and eventually to diabetic coma. Noninsulin-dependent (or type II or maturity-onset) diabetes mellitus develops in adults, usually over 40 years old, because of a decrease in the production of natural insulin, although the pancreas still functions to some extent; alternatively, the body becomes resistant to the effect of insulin. This condition occurs more often in people who are overweight; it is usually treated by diet, weight reduction, and oral hypoglycaemic drugs, but some patients may need insulin instead.

All people with diabetes, regardless of which type, must pay attention to their diet, in which the amount of carbohydrate should be carefully controlled to suit their body’s needs, and be aware of the importance of monitoring blood glucose concentrations. Very low blood glucose (hypoglycaemia) may be caused by excessive dosage of insulin or some oral antidiabetic drugs or by missing a meal. Good control of blood sugar is necessary to prevent such long-term consequences of diabetes as atherosclerosis (giving rise to heart disease), poor circulation in the extremities (causing foot ulcers), impairment
of eyesight, and kidney damage.

Seborrhoeic eczema (or dermatitis) involves the scalp, eyelids, nose, and lips, and is associated with the presence of Pityrosporum yeasts.

Gravitational (or stasis) eczema, incorrectly known as varicose eczema, is associated with poor circulation.
Treatment of eczema is with topical steroids but emollients are very important, especially in treating mild cases.
Other treatments include coal tar and ichthammol. Cyclosporin is reserved for severe atopic eczema that is resistant to other treatments.