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.

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.

Causes

The exact cause of angle-closure 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 2 causes of this narrowing.
• 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 disease

Risk Factors

Angle-closure glaucoma is more common in older 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

You will be asked about your symptoms and medical history. A physical exam will be done. You will be referred to an eye specialist (ophthalmologist).

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 right away if you have any signs or symptoms of an angle-closure glaucoma attack. Treatment options include:

• Medications—Eye drops, pills, and sometimes even IV drugs are given 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.

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

The Canadian Ophthalmological Society http://www.cos-sco.ca

Angle-closure glaucoma. Glaucoma Research Foundation website. Available at:
http://www.glaucoma.org/glaucoma/angle-closure-glaucoma.php
Updated January 14, 2015. Accessed May 26, 2015.

Facts about glaucoma. National Eye Institute website. Available at:
http://www.nei.nih.gov/health/glaucoma/glaucoma_facts.asp
Accessed May 26, 2015.

Vision screening recommendations for adults 40 to 60. Eye Smart—American Academy of Ophthalmology website. Available at:
http://www.geteyesmart.org/eyesmart/living/midlife-adults-screening.cfm
Accessed May 26, 2015.

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 May 26, 2015.

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 May 26, 2015.

What is glaucoma? American Academy of Ophthalmology website. Available at:
http://www.geteyesmart.org/eyesmart/diseases/glaucoma.cfm
Updated December 5, 2014. Accessed May 26, 2015.