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Angle-closure Glaucoma

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

Definition

Glaucoma describes a group of eye diseases that cause damage to the optic nerve. This degenerative eye disease is one of the leading causes of chronic 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 fluid in the front compartment of 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 prevent vision loss.

Glaucoma

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Causes    TOP

The exact cause of angle-closure 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 2 causes of this narrowing.
  • Injury to the eye

Sometimes certain medications can cause sudden angle-closure glaucoma. These include:

  • Adrenergics
  • Anticholinergics
  • Botulism injections around the eye
  • Sulfa-based drugs
  • Phenothiazines and monoamine oxidase inhibitors
  • Medications to treat Parkinson disease

Risk Factors    TOP

Angle-closure glaucoma is more common in older adults and in Asian people. Other factors that may increase your chance of developing angle-closure glaucoma include:

  • Family history of narrow angle glaucoma
  • Injury to the eye
  • Eye drops used to dilate the eyes
  • Certain systemic medications
  • Developing cataracts

Symptoms    TOP

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

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

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. You will be referred to an eye specialist (ophthalmologist).

Tests may include:

  • Eye exam
  • Tonometry—a test 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—to examine the outflow channels of the angle

Treatment    TOP

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

  • Medications—Eye drops, pills, and sometimes even IV drugs are given to reduce intraocular pressure.
  • Surgery—Surgery may be used to stop or prevent an attack of angle-closure glaucoma. This is usually done by laser.

Prevention    TOP

Angle-closure glaucoma cannot be prevented. However, it is important to get regular eye exams to screen for glaucoma and other conditions that can affect your vision. Talk to your doctor about how often your eyes should be examined.

RESOURCES:

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

CANADIAN RESOURCES:

Glaucoma Research Society of Canada
http://www.glaucomaresearch.ca
The Canadian Ophthalmological Society
http://www.cos-sco.ca

References:

Angle-closure glaucoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 15, 2016. Accessed September 28, 2016.
Angle-closure glaucoma. Glaucoma Research Foundation website. Available at:
...(Click grey area to select URL)
Updated January 14, 2015. Accessed June 14, 2016.
Facts about glaucoma. National Eye Institute website. Available at:
...(Click grey area to select URL)
Accessed June 14, 2016.
Vision screening recommendations for adults 40 to 60. Eye Smart—American Academy of Ophthalmology website. Available at:
...(Click grey area to select URL)
Published March 3, 2014. Accessed June 14, 2016.
Vision screening recommendations for adults over 60. American Academy of Ophthalmology Eye Smart website. Available at:
...(Click grey area to select URL)
Published March 3, 2014. Accessed June 14, 2016.
Vision screening recommendations for adults under 40. American Academy of Ophthalmology Eye Smart website. Available at:
...(Click grey area to select URL)
Published July 17, 2012. Accessed June 14, 2016.
What is glaucoma? American Academy of Ophthalmology website. Available at:
...(Click grey area to select URL)
Updated January 10, 2015. Accessed June 14, 2016.
Last reviewed June 2016 by Michael Woods, MD
Last Updated: 9/16/2016

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