• Angle-Closure Glaucoma

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

    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.
    Glaucoma
    si1268 97870 1 glaucoma
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    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 cannot 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

    CANADIAN RESOURCES

    The Canadian Glaucoma Society http://www.eyesite.ca/cgs/

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

    References

    DynaMed Editorial Team. Glaucoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated October 12, 2010. Accessed October 20, 2010.

    International Glaucoma Association. Acute glaucoma (primary angle closure glaucoma). International Glaucoma Association website. Available at: http://www.glaucoma-association.com/nqcontent.cfm?a%5Fid=714&=fromcfc&tt=article&lang=en&site%5Fid=483 . Accessed July 16, 2007.

    National Eye Institute. Glaucoma. National Eye Institute website. Available at: http://www.nei.nih.gov/health/glaucoma/glaucoma%5Ffacts.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.

    World Health Organization. Blindness. World Health Organization website. Available at: http://www.who.int/topics/blindness/en/ . Accessed October 20, 2010.

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