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Angle-Closure Glaucoma(Acute Angle-Closure Glaucoma; Single 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 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 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

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
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/what.php . Updated May 19, 2013. Accessed July 16, 2013.

Angle-closure glaucoma Glaucoma Research Foundation website. Available at: http://www.glaucoma.org/glaucoma/angle-closure-glaucoma.php . Accessed July 16, 2013.

Facts about glaucoma. National Eye Institute website. Available at: http://www.nei.nih.gov/health/glaucoma/glaucoma_facts.asp . Accessed July 16, 2013.

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 16, 2013.

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 16, 2013.

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 16, 2013.

What is glaucoma? American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/diseases/glaucoma.cfm . Accessed July 16, 2013.



Last reviewed July 2013 by Christopher Cheyer, MD; Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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