What are the key symptoms of angle-closure glaucoma. How does this condition differ from open-angle glaucoma. What treatment options are available for angle-closure glaucoma. When should you seek immediate medical attention for acute angle-closure glaucoma.

Understanding Angle-Closure Glaucoma: A Comprehensive Overview

Angle-closure glaucoma, also known as acute glaucoma or narrow-angle glaucoma, is a rare but serious eye condition that requires immediate medical attention. Unlike open-angle glaucoma, which develops gradually, angle-closure glaucoma is characterized by a rapid increase in eye pressure that can lead to permanent vision loss if left untreated.

What causes angle-closure glaucoma?

Angle-closure glaucoma occurs when the drainage canals in the eye become blocked or covered. This blockage prevents the proper outflow of aqueous humor, the clear fluid that fills the front part of the eye. The buildup of fluid leads to a sudden spike in intraocular pressure, which can damage the optic nerve and result in vision loss.

In this condition, the iris (the colored part of the eye) is not as wide and open as it should be. The outer edge of the iris can bunch up over the drainage canals, particularly when the pupil enlarges too much or too quickly, such as when entering a dark room.

Recognizing the Symptoms of Angle-Closure Glaucoma

Identifying the symptoms of angle-closure glaucoma is crucial for seeking timely medical intervention. The most common symptoms include:

• Severe eye pain
• Headaches
• Nausea and vomiting
• Blurred vision
• Halos or rainbows around lights
• Redness in the eye

These symptoms often develop suddenly and can worsen rapidly. If you experience any combination of these symptoms, it’s essential to seek immediate medical attention to prevent permanent vision loss.

How does angle-closure glaucoma differ from open-angle glaucoma?

The primary difference between angle-closure glaucoma and open-angle glaucoma lies in the speed of onset and the nature of the blockage. Open-angle glaucoma develops slowly over time, often without noticeable symptoms in its early stages. In contrast, angle-closure glaucoma can occur suddenly and is characterized by rapid vision loss and severe pain.

Diagnosing Angle-Closure Glaucoma: Tests and Procedures

Early diagnosis of angle-closure glaucoma is crucial for preventing vision loss. Eye care professionals use several tests to diagnose this condition:

1. Tonometry: Measures intraocular pressure
2. Gonioscopy: Examines the drainage angle of the eye
3. Visual field test: Checks for areas of vision loss
4. Optical coherence tomography (OCT): Images the optic nerve and retina

A simple test can determine whether your eye’s angle is normal and wide or abnormal and narrow. This assessment helps eye care professionals identify individuals at risk for angle-closure glaucoma and take preventive measures.

Treatment Options for Angle-Closure Glaucoma

The primary goal of angle-closure glaucoma treatment is to reduce intraocular pressure and prevent further damage to the optic nerve. Treatment options include:

Laser Iridotomy

This procedure involves creating a small hole in the iris using a laser. The hole allows fluid to flow more freely between the anterior and posterior chambers of the eye, reducing pressure and widening the drainage angle.

Conventional Surgery

In some cases, surgical intervention may be necessary to remove a small portion of the bunched-up outer edge of the iris. This procedure, known as peripheral iridectomy, helps unblock the drainage canals and allows extra fluid to drain.

Medications

Eye drops and oral medications may be prescribed to lower intraocular pressure quickly in acute cases. These medications work by either reducing fluid production or increasing fluid outflow.

It’s worth noting that if you have angle-closure glaucoma in one eye, doctors may recommend treating the other eye as a preventive measure. This approach helps reduce the risk of developing the condition in the unaffected eye.

Acute Angle-Closure Glaucoma: A Medical Emergency

Acute angle-closure glaucoma is a severe form of the condition that requires immediate medical attention. In this scenario, the iris may bow forward so much that it completely blocks the eye’s drainage angle, preventing any fluid from escaping. This leads to a rapid and dangerous increase in intraocular pressure.

What are the symptoms of acute angle-closure glaucoma?

The symptoms of acute angle-closure glaucoma are often more severe and develop rapidly. They include:

• Intense eye pain
• Severe headache
• Nausea and vomiting
• Extremely blurred or reduced vision
• Redness in the eye
• Seeing halos around lights

If you experience these symptoms, it’s crucial to seek immediate medical attention. Acute angle-closure glaucoma is a true ophthalmic emergency, and delay in treatment can result in permanent vision loss within hours.

Prevention and Long-Term Management of Angle-Closure Glaucoma

While it’s not always possible to prevent angle-closure glaucoma, there are steps you can take to reduce your risk and manage the condition effectively:

Regular Eye Exams

Routine comprehensive eye exams can help detect early signs of angle-closure glaucoma or identify individuals at risk for developing the condition. Your eye care professional can perform tests to assess the width of your drainage angle and monitor any changes over time.

Lifestyle Modifications

Certain lifestyle changes may help reduce the risk of angle-closure glaucoma or manage the condition if you’ve already been diagnosed:

• Avoid dim lighting conditions that cause pupil dilation
• Stay well-hydrated
• Manage underlying health conditions, such as high blood pressure or diabetes
• Avoid medications that can cause pupil dilation, unless prescribed by your doctor

Prophylactic Treatment

For individuals with narrow angles or those at high risk for angle-closure glaucoma, prophylactic laser iridotomy may be recommended. This preventive procedure can help reduce the risk of developing acute angle-closure glaucoma in the future.

Living with Angle-Closure Glaucoma: Patient Experience and Support

Being diagnosed with angle-closure glaucoma can be a challenging experience. However, with proper treatment and management, many individuals can maintain good vision and quality of life. Here are some tips for living with angle-closure glaucoma:

Adherence to Treatment

Following your prescribed treatment plan is crucial for managing angle-closure glaucoma effectively. This may include taking medications as directed, attending regular follow-up appointments, and undergoing any recommended procedures.

Emotional Support

Coping with a chronic eye condition can be emotionally challenging. Consider joining support groups or seeking counseling to help manage any anxiety or depression related to your diagnosis.

Lifestyle Adaptations

Depending on the severity of your condition, you may need to make some lifestyle adjustments. This could include using assistive devices for reading or driving, modifying your work environment, or learning new ways to perform daily tasks.

Research and Future Directions in Angle-Closure Glaucoma Treatment

Ongoing research in the field of ophthalmology continues to advance our understanding of angle-closure glaucoma and improve treatment options. Some areas of current research include:

Genetic Studies

Researchers are investigating genetic factors that may contribute to the development of angle-closure glaucoma. This could lead to more targeted prevention and treatment strategies in the future.

Advanced Imaging Techniques

New imaging technologies, such as anterior segment optical coherence tomography (AS-OCT), are enhancing our ability to detect and monitor angle-closure glaucoma at earlier stages.

Novel Treatments

Scientists are exploring new therapeutic approaches, including neuroprotective agents and gene therapy, which may help preserve vision in individuals with angle-closure glaucoma.

As research progresses, it’s likely that we’ll see more personalized and effective treatments for angle-closure glaucoma in the coming years. This offers hope for improved outcomes and quality of life for individuals affected by this challenging eye condition.

What is Angle-Closure Glaucoma? | glaucoma.org

What is Angle-Closure Glaucoma? | glaucoma.org

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What is Angle-Closure Glaucoma?

This type of glaucoma is also known as acute glaucoma or narrow angle glaucoma. It is much more rare and is very different from open-angle glaucoma in that the eye pressure usually rises very quickly.

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What is Angle-Closure Glaucoma?

This type of glaucoma is also known as acute glaucoma or narrow angle glaucoma. It is much more rare and is very different from open-angle glaucoma in that the eye pressure usually rises very quickly.

BACK TO BLOG HOME

Angle-Closure Glaucoma happens when the drainage canals get blocked or covered over, like a sink with something covering the drain.

With angle-closure glaucoma, the iris is not as wide and open as it should be. The outer edge of the iris bunches up over the drainage canals, when the pupil enlarges too much or too quickly. This can happen when entering a dark room.

A simple test can be used to see if your angle is normal and wide or abnormal and narrow.

Symptoms of angle-closure glaucoma may include headaches, eye pain, nausea, rainbows around lights at night, and very blurred vision.

Treatment

Treatment of angle-closure glaucoma usually involves either laser or conventional surgery to remove a small portion of the bunched-up outer edge of the iris. Surgery helps unblock the drainage canals so that the extra fluid can drain.

If you have angle-closure glaucoma in one eye, doctors may go ahead and treat the other eye as a safety measure.

In general, surgery for angle-closure glaucoma is successful and long lasting. Regular checkups are still important though, because a chronic form of glaucoma could still occur.

Video Transcript

In cases of acute angle closure glaucoma, the iris may bow forward so much that it cuts off your eye’s angle completely. Unlike narrow angle glaucoma where some fluid can still drain from the eye, acute angle closure glaucoma does not let any fluid drain. It develops quickly and its symptoms can include severe pain, red eye, and nausea. Acute angle closure glaucoma is a medical emergency. If the high pressure is not reduced within hours, it can permanently damage your vision. If you experience any of these symptoms, you should immediately contact your eye doctor or go to a hospital emergency room.

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Acute angle-closure glaucoma: Symptoms, causes, and more

Acute angle-closure glaucoma is a rare but serious type of glaucoma. This condition occurs when drainage canals in the eye become blocked. If a person does not get treatment, acute angle-closure glaucoma can cause serious side effects such as vision loss.

Glaucoma is a group of eye diseases. People with glaucoma experience damage to their optic nerve. This can lead to vision changes over time.

Acute angle-closure glaucoma involves blockage to drainage canals in the eye. This blockage alters pressure within the eye. It can cause headaches, nausea, eye pain, and blurry vision. Immediate treatment is necessary to prevent long-term damage to the eye.

This article will define acute angle-closure glaucoma. It will also explain the symptoms, causes, and treatment of the condition.

Acute angle-closure glaucoma is a rare form of glaucoma. Researchers estimate that it affects up to 4.1 people per 100,000 each year in Europe.

Although this condition is rare, it is a medical emergency. Without prompt treatment, a person with acute angle-closure glaucoma may experience permanent vision loss.

Acute angle-closure glaucoma occurs when there is disruption to the flow of aqueous humor. Aqueous humor is a clear liquid present in the front area of the eye. This liquid helps maintain the shape and function of the eye.

In acute angle-closure glaucoma, there is a blockage to aqueous humor flow between two eye chambers. These chambers are the anterior and posterior chambers. The front part of the eye contains the anterior chamber, while the posterior chamber takes up space between the iris and lens.

Obstruction of the aqueous humor flow changes the pressure between these two chambers. This alters the shape of the iris.

Bowing of the iris narrows the space inside the anterior chamber. This reduces the angle within this chamber. The term “acute angle-closure glaucoma” refers to the narrowing of this angle.

In some cases, the condition can cause vision changes or even blindness. Receiving prompt treatment for this form of glaucoma can reduce the risk of permanent vision loss.

Read about glaucoma here.

The symptoms of acute angle-closure glaucoma typically occur suddenly. They may include:

• blurred vision
• severe pain in one eye
• headache
• vomiting
• nausea
• seeing rainbow-colored rings around bright lights

People experiencing these symptoms should see a medical professional as soon as possible. Immediate treatment is crucial for preventing serious complications of acute angle-closure glaucoma.

Certain people are at a higher risk of developing acute angle-closure glaucoma. People with smaller eyes have a higher chance of developing this condition. This is because they have smaller drainage canals, which can increase the chance of a blockage.

Other risk factors for acute angle-closure glaucoma include:

• being assigned female at birth
• far-sightedness
• older age
• family history of acute angle closure glaucoma

Certain types of medication can also trigger acute angle-closure glaucoma. One recent study investigated which medications were most often associated with this condition.

It found people taking sumatriptan, duloxetine, and topiramate had the highest chance of developing acute angle-closure glaucoma.

Anyone at risk of this condition should speak with a doctor before beginning a new medication. Only a healthcare professional can provide guidance on medication safety and disease risk.

Treatment for acute angle-closure glaucoma involves reducing added pressure within the eye. It also involves treating symptoms such as pain, headache, nausea, and vomiting.

A doctor may administer medications such as acetazolamide, pilocarpine, or glycerol. They can also apply topical glaucoma medications such as beta-blockers or alpha agonists. These medications all help reduce pressure within the eye.

Following these medications, laser treatment can also help treat acute angle-closure glaucoma. This treatment uses a laser beam to restore the flow of aqueous humor.

Anyone with acute angle-closure glaucoma should speak with a healthcare professional to learn more. The condition requires immediate treatment to prevent long-term vision damage.

The following are some questions people frequently ask about acute angle-closure glaucoma.

How serious is acute angle-closure glaucoma?

Acute angle-closure glaucoma is extremely serious. People with this condition require emergency medical attention. If a person does not get treatment, acute angle-closure glaucoma can lead to permanent blindness.

Anyone experiencing the symptoms of this condition should visit an emergency medical center. With an early diagnosis and prompt care, it is possible to recover from this condition.

What is the most common cause of acute angle-closure glaucoma?

Acute angle-closure glaucoma occurs when drainage between different parts of the eye has a blockage. This leads to an increase in pressure within the eye.

Certain people have a higher risk of developing this condition. People assigned female at birth are more likely to experience this condition than people assigned male at birth. Other risk factors include being older or having smaller-than-average eyes.

How quickly can acute angle-closure glaucoma cause blindness?

Acute angle-closure glaucoma can lead to vision loss within 1 day after symptoms begin. These symptoms may include nausea, eye pain, and blurred vision.

Anyone experiencing a sudden onset of these symptoms should visit a healthcare professional immediately. Only a healthcare professional can accurately diagnose and treat acute angle-closure glaucoma.

Acute angle-closure glaucoma is an eye disease that occurs when drainage canals in the eyes have an obstruction. This blockage increases pressure within the eye and can lead to serious complications.

Without prompt treatment, acute angle-closure glaucoma can cause permanent vision loss.

The symptoms of this eye disease typically appear suddenly. They may include eye pain, blurred vision, headache, nausea, and vomiting.

A person experiencing symptoms of this condition should see a doctor immediately. Early diagnosis and treatment can help prevent long-term health consequences.

Open-angle glaucoma – signs, diagnosis, treatment, prevention

Contents

1. Primary open-angle glaucoma
2. Causes
3. Signs of the disease
4. Diagnosis
5. Treatment
6. Prevention and prognosis

Open-angle glaucoma – progressive chronic eye disease, accompanied by an increase in intraocular pressure, which eventually leads to damage to the optic nerve. Among its clinical symptoms, it is necessary to highlight the decrease in visual acuity and deterioration of accommodation. Often the disease is accompanied by painful sensations. To diagnose the disease, tonometry, gonioscopy, OCT, perimetry and ophthalmoscopy are performed. The methods of complex treatment include: drug therapy, laser methods of exposure, surgical operations (sinus trabeculectomy, sclerectomy).

Primary open-angle glaucoma

This disease is one of the most common ophthalmic causes of disability. Primary open-angle glaucoma (POAG) is accompanied by a periodic or regular increase in intraocular pressure (IOP), which exceeds the values ​​individually tolerated by a person. In addition, the progression of the disease causes pathological disorders in the optic nerve head and the structure of retinal ganglion cells, which leads to a deterioration in the quality of vision and ends in blindness.

Pathology is caused by an increase in IOP with an open angle of the anterior chamber, which distinguishes it from the angle-closure form of the disease. According to WHO, today in the world there are at least 70 million people with this disease, which holds the second place as the cause of irreversible vision loss. The onset of the disease is especially susceptible to people over 60 years of age (3-4%), however, in 2% of the population it is recorded already after 45 years. In rare cases, the disease affects young people (up to 20 years).

Causes

Open-angle glaucoma is a disease that largely depends on the genetic predisposition and the existing polygenic transmission mechanism. There are many prerequisites for its occurrence, although what exactly triggers the pathological process has not yet been established.

The main role in development belongs to the functional blockade of the scleral sinus. The following anatomical features of the eye can lead to it: pathologies of attachment of the scleral spur or ciliary muscle, low angle of inclination of the Schlemm canal, etc. The severity of these changes tend to progress with age, which leads to the disease.

It has been established that prolonged therapy with glucocorticoids leads to a decrease in the permeability of the trabecular meshwork and prevents the removal of intraocular fluid. The resulting increase in IOP causes damage to the optic nerve head. An important link in the pathogenesis of POAG is changes in the mechanism of regulation of blood flow in the optic nerve head. The risk of developing an open-angle form of the disease is especially high in people with atherosclerosis, hypertension, diabetes mellitus, high degrees of myopia and chronic diseases associated with metabolic disorders.

Signs of the disease

Specialists commonly distinguish several forms of open-angle glaucoma:

• simple primary open-angle glaucoma
• pigmentary glaucoma
• pseudoexfoliative open-angle glaucoma 9000 8
• normal pressure glaucoma

both eyes are involved. The disease has an almost asymptomatic course, especially in the early stages of development. As the process progresses, subjective symptoms are added: accommodation decreases; when looking at a light source, rainbow circles and halos are visible; flickering or fog appears before the eyes. When the rise in IOP exceeds the tolerable values, patients report a headache that may radiate to the eyes or brow ridges.

Pigmentary form – the result of applying the pigment of the iris with a current of intraocular fluid to the area of ​​the corneal-scleral septum. The increase in pressure is due to a violation of the circulation of aqueous humor.

The pseudoexfoliative form of the disease usually occurs in individuals with exfoliative syndrome. Pathology is characterized by the deposition of a small layer of amyloid-like substance along the anterior pole of the eyeball. The degree of severity of eye damage in this case is very diverse. The pathognomonic symptoms of pseudoexfoliative glaucoma include: a change in the contour of the pupil, the absence of pigmentation of the central part of the iris, trembling of the lens (phacodonez) during eye movements. Glaucoma of this form is characterized by higher IOP values, as well as a progressive course.

Normal pressure glaucoma occurs in people over 35 years of age. The degree of damage to both eyes, as a rule, is different. Among the distinguishing symptoms of the disease are normal IOP values ​​and an open angle of the anterior chamber. The triggering mechanism of the disease is considered to be spasms of large vessels against the background of arterial hypertension.

Diagnosis

Measurement of intraocular pressure is a key diagnostic tool in the detection of open-angle disease. It is performed using the following methods:

• Tonometry, elastotonometry, daily tonometry. In the latter case, the doctor receives data on changes in intraocular pressure during the day.
• Biomicroscopy. The area of ​​the fundus, the field of view, as well as the angle of the anterior chamber are subject to research.
• The degree of openness of the anterior chamber angle can be visualized using gonioscopy. It can also be used to detect increased pigmentation, increased density of the corneal-scleral trabecula, as well as the development of sclerotic changes in it.
• To determine the narrowing of the visual fields, the perimetry method is used, which also reveals the causes of the condition – paracentral scotomas and Björum’s scotomas. The narrowing begins from the nasal half, and, at the terminal stage, the patient no longer sees anything.
• Ophthalmoscopic examination reveals the pallor of the optic disc and the expansion of the boundaries of its vascular funnel. With the progression of the disease, atrophy of the second pair of nerves of the skull and vascular plexuses of the eye occurs, which leads to the development of a subsequent ring of prepapillary atrophy.
• The appointment of OCT allows to reveal the details of the pathological process in the involved structures.

Open-angle glaucoma is differentiated from age-related cataract.

Treatment

Antihypertensive drug therapy is the first step in the treatment of open-angle glaucoma. For this purpose, eye drops are prescribed to improve the outflow of intraocular fluid. These drugs include M-cholinomimetics (Pilocarpine) and prostaglandins (Latanoprost, Travoprost). Adrenoblockers (Timolol, Proxodolol), as well as carbonic anhydrase inhibitors (Diacarb) and alpha-2-agonists (Brimonidine) help to effectively reduce the production of intraocular fluid.

Diuretics (Mannitol) also help reduce IOP. An obligatory component of neuroprotective therapy is vitamins and essential flavonoids (Vitamin E, gamma-aminobutyric acid), calcium channel blockers (Nifedipine) and antioxidants (Mexidol) are prescribed.

Laser treatments for open-angle glaucoma are somewhat limited. If a patient has a narrow corneal-scleral angle, laser iridectomy may be performed. When conservative therapy shows insufficient effect, it is possible to use selective laser trabeculoplasty.

The surgical treatment of open-angle glaucoma is a sinustrabeculectomy operation. Surgical intervention refers to non-penetrating filtering interventions.

In the postoperative period, patients are recommended to give up pickles and marinades for 10 days, to exclude alcohol. It is strictly forbidden to touch the eye or rub it. It is also worth avoiding contact with the wound surface of water and detergents. In addition, physical activity should be limited. For sleep, it is better to choose the side opposite to where the operated eye is located. In the future, patients after antiglaucoma surgery are recommended to undergo control examinations by an ophthalmologist twice a year.

Prognosis and prevention

Modern ophthalmological methods, unfortunately, cannot provide complete recovery for people with glaucoma. However, treatment is an urgent need, as the disease has a progressive course, which in the terminal stage leads to irreversible blindness.

In the early stages of glaucoma, with adequate timely treatment, the prognosis for vision is favorable. In the advanced stages of the disease, it is possible to obtain a disability group, the basis for which is a serious decrease in visual acuity.

There are no specific measures to prevent glaucoma. Therefore, in order to prevent the dangerous consequences of the disease, people over 40 years old, especially those who have already been diagnosed with glaucoma in the family, need to undergo routine examinations with an ophthalmologist. When diagnosing open-angle glaucoma, all patients should be registered with a dispensary and visit a specialist every 2-3 months.

Open-angle glaucoma treatment

Eye disease in the form of glaucoma in our time is very common among different categories of the population. The most common type of glaucoma is the open-angle form of the disease. It is alarming that in this disease the percentage of risk of complete loss of vision is quite high.

The primary stage of open-angle glaucoma is increasingly diagnosed in young people, although not so long ago this disease was inherent in the older generation.

This form of glaucoma is dangerous because it proceeds for a long time without noticeable symptoms, gradually and up to a certain time imperceptibly taking away the patient’s field of vision. Thus, patients turn to an ophthalmologist already at a late, advanced stage, when treatment is often powerless and loss of vision is inevitable.

The main cause of eye disease in the form of glaucoma is a violation of the process of fluid circulation in the organ of vision. Very often, this reduces the throughput of the drainage system of the eye up to its complete obstruction, which leads to the accumulation of fluid and, accordingly, to an increase in intraocular pressure. The next stage is the destruction of the optic nerve. It’s no secret that nerve fibers cannot be restored – this is the whole insidiousness of glaucoma.

Causes of open-angle glaucoma

Often primary open-angle glaucoma occurs in the following cases:
1. With the inevitable changes associated with the aging of the body.
2. With the individual characteristics of human anatomy – the dark iris of the eye is more prone to glaucoma.
3. Heredity.
4. With the abuse of bad habits.
5. Diseases of the cardiovascular system, disorders of the nervous or autonomic system.
6. Myopia of the eyes can also cause glaucoma.

Open-angle glaucoma – symptoms

Often in the open-angle form, glaucoma occurs in two eyes, but it can be either simultaneously or alternately.

In 15% of patients, there is a periodic appearance of rainbow circles or a foggy effect before the eyes.
But these symptoms are temporary and appear in the event of an increase in intraocular pressure, and disappear when it decreases.

Glaucoma can also be seen when peripheral vision is narrowed.

In any case, you should not hesitate, but rather consult a specialist, then there is a chance of effective treatment.
If you start the disease, then it will go into a far advanced state and the treatment will already be powerless, and vision will eventually fall and blindness may occur.