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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_facts.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.



Last reviewed June 2014 by Eric Berman, 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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