Angle Closure Glaucoma

Also known as acute angle glaucoma or narrow angle glaucoma, angle closure glaucoma is much rarer than open angle glaucoma. It is also very different and potentially more dangerous because intraocular pressure can rise very quickly, leading to rapid damage of the optic nerve.

Causes of Angle Closure Glaucoma

Fluids produced in the eye normally flow over the lens, through the pupil into the anterior chamber (between the cornea and the iris), then out of the eye through what is known as the open angle, a spongy network of tissue. In angle closure glaucoma, this route gets blocked.

Sometimes, the iris blocks the open angle when your pupil dilates in response to dim light or medications, including eye drops given during an eye exam. Other times, the iris adheres to the lens, which may restrict flow out through the pupil, pushing the iris forward and closing the angle. Angle closure glaucoma can also be a type of secondary glaucoma, caused by an infection, injury or occulotumor.

Angle Closure Glaucoma Risk Factors

The main risk factor for angle closure glaucoma is the presence of a narrow or acute angle. You may be more likely to have an acute angle depending on your:

Eyesight: farsighted people often have shallow anterior chambers and narrow angles
Age: the anterior chamber shallows as we age, narrowing the open angle
Race: Persons of Asian or Eskimo descent often have narrower angles than Caucasians
Sex: Among Caucasians, women are more likely to experience angle closure glaucoma

Whether you have risk factors or not, your ophthalmologist should determine if you have an acute angle as part of a routine eye exam, and you should be aware of the symptoms of angle closure glaucoma.

Symptoms of Angle Closure Glaucoma

Unlike most types of glaucoma, angle closure glaucoma produces noticeable symptoms, including:

Eye pain
Red eyes
Halos around lights
Headaches
Nausea
Vomiting
Vision loss

Symptoms may go away after several hours or persist until treatment lowers your intraocular pressure. Angle closure glaucoma is a medical emergency. If you experience the symptoms of angle closure glaucoma, contact your ophthalmologist immediately or go directly to the emergency room to avoid possible vision loss.

Treatment of Angle Closure Glaucoma

Because of the potential for rapid and permanent vision loss, treatment for angle closure glaucoma is designed to rapidly decrease intraocular pressure using some or all of these treatments:

Systemic medications to reduce blood pressure and intraocular pressure
Glaucoma eye drops to reduce pressure
An iridotomy in which a laser is used to create a microscopic drain in the iris
An iridectomy, in which a portion of the iris is surgically removed to ease fluid pressure

Which treatments are used depends on your ophthalmologist's preferences and the exact circumstance of your glaucoma.

Preventing Vision Loss from Angle Closure Glaucoma

The key to preventing vision loss due to angle closure glaucoma is to recognize the signs early and receive rapid treatment. If you are at risk for angle closure glaucoma, but don't know whether you have a narrow angle or not, you should schedule a vision exam and be sure to ask your ophthalmologist if you have an acute or narrow angle. Find an ophthalmologist in your area and schedule an exam today.