Angle-Closure Glaucoma

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

    Glaucoma represents a group of eye disorders that may cause damage to the optic nerve due to high intraocular pressure. 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 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 preserve vision.
    Glaucoma
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  • Causes

    The exact cause of narrow-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—more common in people who are Asian
    • 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's disease
  • Risk Factors

    Angle-closure glaucoma is more common in older aging 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

    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

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    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

    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 may be used to stop or prevent an attack of angle-closure glaucoma. This is usually done by laser.
  • Prevention

    Angle-closure glaucoma can't be prevented. Regular eye exams are important to screen for eye conditions such as glaucoma.
  • RESOURCES

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

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

    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 website. Available at: http://www.ebscohost.com/dynamed. Updated May 16, 2014. Accessed July 17, 2014.

    Angle-closure glaucoma. Glaucoma Research Foundation website. Available at: http://www.glaucoma.org/glaucoma/angle-closure-glaucoma.php. Updated March 29, 2013. Accessed July 17, 2014.

    Facts about glaucoma. National Eye Institute website. Available at: http://www.nei.nih.gov/health/glaucoma/glaucoma%5Ffacts.asp. Accessed July 17, 2014.

    Vision screening recommendations for adults 40 to 60. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/living/midlife-adults-screening.cfm. Accessed July 17, 2014.

    Vision screening recommendations for adults over 60. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/living/seniors-screening.cfm. Accessed July 17, 2014.

    Vision screening recommendations for adults under 40. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/living/young-adults-screening.cfm. Accessed July 17, 2014.

    What is glaucoma? American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/diseases/glaucoma.cfm. Updated September 1, 2013. Accessed July 17, 2014.

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