Angle-Closure Glaucoma

(Acute Angle-Closure Glaucoma; Single Angle-Closure Glaucoma)

by Diana Kohnle

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

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Definition

Glaucoma represents a group of eye disorders that cause damage to the optic nerve. Glaucoma is a degenerative eye disease and one of the leading causes of blindness in the United States.

Angle-closure glaucoma is a condition in which the iris in the eye shifts and blocks the exit passageway of the aqueous humor, the fluid that fills the eye. This fluid blockage causes a rapid build-up of pressure in the eye.

Angle-closure glaucoma is an emergency condition that requires immediate medical treatment to preserve vision.

Causes

The exact cause of open-angle glaucoma is unknown. However, factors that play a role in causing the disease include:

• Narrowing of the drainage angle in the eye-Aging and being farsighted are two causes of this narrowing.
• Being born with narrow angles
• Injury to the eye

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your chance of developing angle-closure glaucoma:

• Family history of narrow angle glaucoma
• Glaucoma in one eye-This increases the risk of developing glaucoma in the other eye.
• Ethnic background-Asians are at greater risk of angle-closure glaucoma.
• Injury to the eye
• Eye drops used to dilate the eyes
• Certain systemic medications

Symptoms

Patients with narrow angles experience few or no symptoms until the disease has progressed to an acute angle-closure attack. Symptoms of this may include:

• Severe pain in the eye
• Facial pain
• Pupil not reacting to light
• Blurred or cloudy vision
• Nausea
• Vomiting
• Redness and swelling of the eye

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include the following:

• Eye exam
• Tonometry -to determine intraocular pressure
• Slit lamp examination-the use of a low-power microscope combined with a high-intensity light source, allows a narrow beam that can be focused to examine the front of the eye
• Gonioscopy-the use of a special mirror to view the drainage angle of the eye

Treatment

Angle-closure glaucoma requires emergency medical treatment to preserve vision. See an ophthalmologist immediately if you have any signs or symptoms of an angle-closure glaucoma attack. Treatment options include:

• Medications-Eye drops, pills, and sometimes even intravenous drugs are often administered to reduce intraocular pressure.
• Surgery-Surgery (usually done by laser) may be used to stop or prevent an attack of angle-closure glaucoma.

Prevention

Angle-closure glaucoma cannot be prevented, but prompt medical treatment can reduce the risk of vision loss. Patients at high risk of having an angle-closure glaucoma attack may undergo preventive surgery to open a new channel in the iris. Since you can't tell if you have narrow angles, it is important to have a comprehensive eye examination regularly.

RESOURCES:

The Glaucoma Foundation
http://www.glaucomafoundation.org/

Glaucoma Research Foundation
http://www.glaucoma.org/index.php

St. Luke's Eye Cataract & Laser Institute
http://www.stlukeseye.com/

CANADIAN RESOURCES:

Glaucoma Canada
http://www.glaucomacanada.com/

Glaucoma Research Society of Canada
http://www.glaucomaresearch.ca/

REFERENCES:

Acute glaucoma (primary angle closure glaucoma). International Glaucoma Association website. Available at: http://www.glaucom... . Accessed July 16, 2007.

Blindness. World Health Organization website. Available at: http://www.who.int/topics/blindness/en/ .

Glaucoma. Medline Plus Medical Encyclopedia. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001620.htm . Accessed June 27, 2007.

Glaucoma. US National Institutes of Health. National Eye Institute website. Available at: http://www.nei.nih.gov/health/glaucoma/glaucoma_facts.asp . Accessed June 27, 2007.

Spaeth G. What is angle closure glaucoma? Glaucoma Service Foundation to Prevent Blindness website. Available at: http://wills-glaucoma.org/aclose.htm . Accessed June 27, 2007.

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Last reviewed September 2009 by Christopher Cheyer, MD
Last Updated: 9/30/09