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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
si1268 97870 1 glaucoma
Copyright © Nucleus Medical Media, Inc.

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.

Revision Information

  • Reviewer: Eric Berman, MD
  • Review Date: 06/2014 -
  • Update Date: 07/17/2014 -
  • The Glaucoma Foundation

    http://www.glaucomafoundation.org

  • Glaucoma Research Foundation

    http://www.glaucoma.org/index.php

  • Glaucoma Research Society of Canada

    http://www.glaucomaresearch.ca

  • The Canadian Ophthalmological Society

    http://www.cos-sco.ca

  • 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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