GLAUCOMA, ANGLE-CLOSURE

 Basic information

description

Glaucoma is a group of disorders that lead to damage to the optic nerve (the nerve connecting the eye to the brain). Angle-closure glaucoma is one of the two main types of glaucoma, and is more rare. (Open-angle glaucoma is the more common and frequently occurring type.) Angle-closure glaucoma symptoms can occur suddenly (acute), or develop over time (chronic). It occurs more often in people over 55 and in women more than in men.

FREQUENT SIGNS & SYMPTOMS

• Acute angle-closure glaucoma (symptoms are sudden, and often occur in a darkened room, such as a movie theater, or during periods of stress):
  • Severe, throbbing eye pain. Eye becomes red.
  • Blurred vision.
  • May see halos around lights.
  • Nausea, vomiting, and headache.
• Chronic angle-closure glaucoma (not acute):
  • There may be no symptoms.
  • Slightly blurred vision, mild eye pain, or seeing halos around lights. These symptoms may come and go.

causes

Normal eye pressure (intraocular pressure or IOP) is maintained by a balance of fluid (aqueous humor) that flows into the front of the eye and then drains out. The angle of the eye (where the iris and cornea meet) is where the drains (called trabecular meshwork) are located. With angle-closure glaucoma, the angle of the eye is not as wide (or open) as it should be. When the pupil dilates (gets larger), it pushes or pulls up the iris and narrows the angle even more so the drain is blocked or covered over. In acute cases, this happens suddenly. In chronic cases, it occurs over time. The blocked drain causes a buildup of fluid and pressure in the eye. The pressure can damage the optic nerve, sometimes within hours, and lead to vision loss.

risk increases with

• Adults over 55. Females more than males.
• Family history of glaucoma.
• Having small eyes or farsighted eyes.
• Asian or Eskimo descent.
• One eye has had acute angle-closure glaucoma.
• Use of certain drugs or having certain eye diseases.

PREVENTIVE MEASURES

• Get regular eye exams. Your eye care provider will recommend a routine depending on your age, general health, and your risk factors for eye problems.
• Get medical care for any changes in your vision.

expected outcomes

Symptoms can usually be controlled with treatment.

possible complications

With acute angle-closure, decreased or loss of vision in the affected eye. Acute attack may occur in other eye.

 diagnosis & treatment

general measures

• Your eye health care provider (ophthalmologist) will perform eye tests. These may include tonometry (measures pressure), gonioscopy (a test to check the angle of the eye), slit lamp exam (to look inside the eye), optic nerve imaging, or others as needed.
• An acute angle-closure glaucoma attack is an emergency situation. Chronic angle-closure glaucoma may be diagnosed on a routine eye exam. Treatment of either is with drugs and/or surgery.
• Laser iridotomy surgery to reduce fluid pressure is often done. An iridectomy is surgery done with miniature instruments. A small opening is made in the iris so that the aqueous humor (fluid in the eye) can drain. It may be done in the other eye as a preventive measure.
• To learn more: Glaucoma Foundation, 80 Maiden Lane, Suite 700, New York, NY 10038; (800) 452-8266; website: www.glaucomafoundation.org.

medications

• For emergency care, drugs are given to constrict the pupil and to reduce the fluid production of the eye. The drugs may be taken by mouth (oral), injected into a vein (IV), or topical drops into the eye.
• Eye drops may be prescribed to lower pressure inside the eye. Follow the instructions and schedule carefully.

activity

No limits after treatment, unless advised otherwise.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of acute angle-closure glaucoma. This is an emergency!
• Vision or eye problems recur or new eye symptoms develop after treatment.

Special Notes: