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

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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.

Revision Information

• Reviewer: Christopher Cheyer, MD
• Update Date: 09/01/2011