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Angle-Closure Glaucoma: What You Need to Know

Angle-Closure, also referred to as narrow-angle glaucoma, is a very rare and serious type of glaucoma. Angle-closure can be chronic (long-lasting) or can occur suddenly. Normally, fluid produced in the eye flows between the lens and the back of the iris, through the pupil, then out through the angle. When the lens and the iris stick together, the fluid presses on the iris, forcing the angle into a closed position, and the eye pressure can rise dramatically.

When it occurs suddenly, this condition is referred to as “acute angle-closure glaucoma.” Unlike other types of glaucoma which cause pressure buildup in the eye over a prolonged period of time, acute angle-closure glaucoma occurs when the pressure inside the eye rises suddenly, even over a matter of hours. 

What Is Angle-Closure Glaucoma?

The angle of the eye, or the site of the eye’s drainage system, is located where the iris (the colored part of the eye) meets the cornea (the clear part of the eye). If the iris and the cornea are in contact, whether naturally very close to each other or actually sealed together, this is known as angle-closure. As the eye ages, the natural lens behind the pupil grows and the pupil becomes smaller, restricting the flow of fluid to the drainage site. Fluid can build up behind the iris, pushing it forward and blocking the channel, or angle, that normally allows fluid to drain. If a blockage happens, a rapid rise in intraocular pressure can occur. This is what is called angle-closure glaucoma.

This form of glaucoma affects less than 10 percent of patients with glaucoma and is the most serious form of the disease. It is found more commonly in farsighted elderly people, particularly women, who are 2 to 4 times more likely to have the disease than men. The chances of developing angle-closure glaucoma increase with age, and often occurs in both eyes. 

What Are the Symptoms, Causes & Risk Factors of Angle-Closure Glaucoma?

Narrow-angle glaucoma can be very painful due to the sudden pressure rise in the eye. The symptoms of an acute attack of angle-closure glaucoma can include blurred vision, halos around lights, eye pain, eye redness, and pain in the eyebrow area. These symptoms should be heeded as they should be understood as warning signs of a serious condition developing in the eye. Occasionally, an individual can have these symptoms off and on without going into a full-blown attack. The drainage angle may only be partially or temporarily blocked. In this case these symptoms should be understood as a warning that an acute attack will develop. An acute attack, an attack in which the drainage angle is totally blocked, may be extremely painful and be accompanied by nausea and vomiting. This is a serious medical situation and should be treated as an emergency. If you experience these symptoms, call or eye doctor immediately and go to the emergency. Immediate treatment can save some permanent eye damage. 

What Are the Medications and Treatments for Angle-Closure Glaucoma?

Treatment for angle-closure is known as peripheral iridotomy. Peripheral iridotomy is a procedure performed with lasers that creates a new perforation in the iris. This opening allows the aqueous fluid that has been trapped to drain through the angle of the eye. Due to the risk of the condition developing in both eyes, a peripheral iridotomy may be done in both eyes. If discovered and treated in its early stages, angle-closure glaucoma can be managed. Without treatment, optic nerve damage can occur and ancillary types of glaucoma may develop in other parts of the eye.   

How Tucker & Associates Can Help 

The easiest way to determine if you have narrow angle-closure glaucoma is to see your eye doctor of a thorough eye examination including a test called a gonioscopy where the doctor will determine whether the angle where the iris meets the cornea is open or closed. 


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