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by Kohnle D

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.
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 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.

RESOURCES

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

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 April 17, 2015. Accessed May 26, 2015.
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%5Ffacts.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.

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