Angle-Closure Glaucoma

Angle-Closure Glaucoma: Understanding a Sight-Threatening Condition

Angle-closure glaucoma, also known as acute angle-closure glaucoma or narrow-angle glaucoma, is a serious eye condition that requires immediate medical attention. It occurs when the drainage angle in the eye becomes blocked, leading to a rapid increase in intraocular pressure (IOP). This elevated pressure can damage the optic nerve, resulting in vision loss if left untreated.

In this comprehensive guide, we will explore the intricacies of angle-closure glaucoma, including its causes, symptoms, diagnosis, treatment options, and preventive measures.

Understanding Angle-Closure Glaucoma

 

To comprehend angle-closure glaucoma, it’s essential to understand the normal anatomy and function of the eye.

The front part of the eye contains a clear fluid called aqueous humor, which nourishes the eye and maintains its shape. This fluid is continuously produced and drained through a drainage angle located at the junction of the iris (the colored part of the eye) and the cornea (the clear front surface of the eye).

In angle-closure glaucoma, the iris bulges forward, narrowing or blocking the drainage angle. This obstruction prevents the aqueous humor from draining properly, leading to a rapid increase in IOP.

Causes and Risk Factors

Several factors can contribute to the development of angle-closure glaucoma:

• Anatomical predisposition: People with naturally narrow drainage angles are at a higher risk.
• Age: The risk increases with age, as the lens of the eye thickens and pushes the iris forward.
• Ethnicity: People of Asian descent have a higher prevalence of angle-closure glaucoma.
• Family history: A family history of angle-closure glaucoma increases the risk.
• Farsightedness (hyperopia): People with farsightedness have a shorter eyeball, which can crowd the structures in the front of the eye and increase the risk of angle closure.
• Pupil dilation: Certain medications or situations that cause the pupil to dilate can trigger an acute angle-closure attack in susceptible individuals.

Symptoms of Angle-Closure Glaucoma

Angle-closure glaucoma can manifest in two ways: acute angle-closure glaucoma and chronic angle-closure glaucoma.

• Acute Angle-Closure Glaucoma: This is a medical emergency and requires immediate attention. Symptoms include:

  • Severe eye pain
  • Blurred vision
  • Nausea and vomiting
  • Halos around lights
  • Redness of the eye

• Chronic Angle-Closure Glaucoma: This develops gradually and may not cause noticeable symptoms until significant vision loss has occurred. Symptoms may include:

  • Mild eye pain or discomfort
  • Blurred vision
  • Halos around lights

Diagnosis of Angle-Closure Glaucoma

 

Early diagnosis is crucial for preventing vision loss from angle-closure glaucoma. An eye doctor will perform a comprehensive eye examination, which may include:

• Tonometry: Measuring the intraocular pressure using a tonometer.
• Gonioscopy: Examining the drainage angle using a special lens.
• Ophthalmoscopy: Examining the optic nerve for any signs of damage.
• Visual field testing: Assessing the peripheral vision.

Treatment Options for Angle-Closure Glaucoma

The primary goal of treatment is to lower the IOP and prevent further damage to the optic nerve.

• Acute Angle-Closure Glaucoma: Immediate treatment is necessary to reduce IOP and prevent permanent vision loss. Treatment options include:

  • Medications: Eye drops and oral medications to lower IOP.
  • Laser iridotomy: A laser procedure to create a small hole in the iris, allowing for better drainage of aqueous humor.
  • Surgical iridectomy: A surgical procedure to remove a small portion of the iris, creating a new drainage pathway.

• Chronic Angle-Closure Glaucoma: Treatment focuses on preventing further angle closure and lowering IOP. Treatment options include:

  • Laser iridotomy
  • Medications
  • Surgery, if other treatments are not effective.

Prevention of Angle-Closure Glaucoma

Early detection and preventive measures are key to avoiding vision loss from angle-closure glaucoma.

• Regular eye exams: People at risk, especially those with a family history or anatomical predisposition, should have regular comprehensive eye exams, including gonioscopy.
• Prophylactic laser iridotomy: For individuals with narrow angles but no symptoms, a preventive laser iridotomy may be recommended to reduce the risk of an acute attack.

Living with Angle-Closure Glaucoma

While angle-closure glaucoma can be a serious condition, with prompt diagnosis and treatment, most people can maintain good vision.

Here are some tips for managing angle-closure glaucoma:

• Adhere to your treatment plan: Take your medications as prescribed and attend follow-up appointments with your eye doctor.
• Be aware of symptoms: Report any new or worsening symptoms to your doctor immediately.
• Protect your eyes: Wear sunglasses to protect your eyes from bright light and avoid activities that increase IOP, such as heavy lifting.

The Importance of Early Detection and Treatment

Early detection and prompt treatment are crucial for preserving vision in angle-closure glaucoma. If you experience any symptoms or are at risk for this condition, don’t hesitate to seek professional medical advice.

Conclusion

Angle-closure glaucoma is a sight-threatening condition that requires immediate medical attention. Understanding the causes, symptoms, diagnosis, and treatment options can help you take proactive steps to protect your vision. Remember, early detection and appropriate management are key to preventing vision loss and maintaining a good quality of life.

Disclaimer: This blog post is intended for informational purposes only and should not be considered a substitute for professional medical advice. Always consult your doctor for diagnosis and treatment of any medical condition.