Angle-Closure Glaucoma: Symptoms, Causes, Treatment

What are the symptoms of angle-closure glaucoma?

Angle-closure glaucoma, also known as acute or narrow-angle glaucoma, is a serious form of glaucoma that requires immediate medical attention. It occurs when the fluid pressure inside the eye (intraocular pressure) increases rapidly, leading to a sudden and severe increase in pressure. This can cause damage to the optic nerve and result in vision loss if not treated promptly.

Symptoms of angle-closure glaucoma can include:

1. Severe Eye Pain: This is often described as a deep ache in the eye or brow region and may be accompanied by headache or facial pain.
2. Blurred Vision: Vision may become blurred or cloudy, and there may be halos or rainbow-colored rings around lights.
3. Redness in the Eye: The affected eye may appear red due to the increased pressure and irritation.
4. Decreased or Tunnel Vision: Vision may be reduced or narrowed, with a sensation of looking through a tunnel.
5. Nausea and Vomiting: Some people may experience nausea and vomiting, often due to the severe pain and pressure in the eye.
6. Sudden Vision Loss: In severe cases, there may be a sudden and complete loss of vision in the affected eye.

It’s important to note that not everyone with angle-closure glaucoma will experience all of these symptoms, and the severity of symptoms can vary. If you experience any of these symptoms, especially sudden and severe eye pain, blurred vision, or nausea and vomiting, seek immediate medical attention. Angle-closure glaucoma is considered a medical emergency and requires prompt treatment to prevent vision loss.

What are the causes of angle-closure glaucoma?

Angle-closure glaucoma occurs when the fluid pressure inside the eye (intraocular pressure) increases rapidly due to the sudden and complete blockage of the drainage angle in the eye. This blockage prevents the normal outflow of fluid (aqueous humor) from the eye, leading to a buildup of pressure. Several factors can contribute to the development of angle-closure glaucoma, including:

1. Anatomical Structure of the Eye: People with a narrow drainage angle in their eyes are at higher risk of developing angle-closure glaucoma. In these individuals, the iris may be positioned more closely to the drainage angle, increasing the risk of blockage.
2. Age: Angle-closure glaucoma is more common in older adults, particularly those over the age of 40.
3. Genetics: There may be a genetic predisposition to angle-closure glaucoma, as it tends to run in families.
4. Hyperopia (Farsightedness): Farsighted individuals are at higher risk of angle-closure glaucoma because their eyes are often smaller and more likely to have a narrow drainage angle.
5. Certain Medications: Some medications, such as certain types of antidepressants, antihistamines, and decongestants, can cause the pupil to dilate and increase the risk of angle-closure glaucoma in susceptible individuals.
6. Eye Trauma or Surgery: Previous eye trauma or surgery can cause inflammation or scarring that may contribute to the development of angle-closure glaucoma.
7. Ethnicity: Angle-closure glaucoma is more common in people of Asian descent.

It’s important to note that angle-closure glaucoma can occur suddenly (acute angle-closure glaucoma) or develop gradually over time (chronic angle-closure glaucoma). Acute angle-closure glaucoma is a medical emergency and requires immediate treatment to prevent permanent vision loss. Chronic angle-closure glaucoma may not cause symptoms until the disease has progressed, so regular eye exams are essential for early detection and treatment.

What is the treatment for angle-closure glaucoma?

Angle-closure glaucoma is a medical emergency that requires prompt attention to prevent vision loss and blindness. The treatment for angle-closure glaucoma involves a combination of medications, laser surgery, and invasive surgical procedures. The goal of treatment is to reduce the intraocular pressure (IOP) and restore the drainage of the eye.

Initial Treatment

1. Medications: Topical or oral medications may be used to reduce IOP. These medications include:
   • Beta-blockers (e.g., timolol) to reduce aqueous humor production.
   • Carbonic anhydrase inhibitors (e.g., dorzolamide) to reduce aqueous humor production.
   • Hyperosmotic agents (e.g., mannitol) to reduce IOP by increasing the osmolarity of the aqueous humor.
2. Iopidine: A medication that helps to reduce the IOP by decreasing the production of aqueous humor.

Laser Surgery

1. Laser iridotomy: A laser beam is used to create a small hole in the iris, allowing the aqueous humor to drain from the eye. This procedure is often performed in combination with other treatments.
2. Laser trabeculoplasty: A laser beam is used to stimulate the trabecular meshwork, which helps to increase the drainage of the eye.

Invasive Surgical Procedures

1. Trabeculectomy: A surgical procedure that creates a new pathway for the aqueous humor to drain from the eye.
2. Drainage implant: A device that is implanted in the eye to help drain the aqueous humor.
3. Ahmed valve: A device that is implanted in the eye to help drain the aqueous humor.

Other Treatments

1. Eye drops: To reduce IOP and prevent further damage.
2. Medications: To reduce IOP and prevent further damage.
3. Pilocarpine: A medication that can be used to help reduce IOP and prevent further damage.

Emergency Treatment

If you are experiencing symptoms of angle-closure glaucoma, such as sudden vision loss, eye pain, or nausea, seek immediate medical attention. In these cases, treatment may involve:

1. Immediate medication: To reduce IOP and prevent further damage.
2. Laser iridotomy: To create a new pathway for the aqueous humor to drain from the eye.
3. Surgical intervention: To restore drainage of the eye.

It’s essential to work closely with your eye care provider to develop a treatment plan that is tailored to your specific needs and situation.

How can I prevent angle-closure glaucoma?

Preventing angle-closure glaucoma is crucial, as it can lead to severe vision loss and blindness if left untreated. While there is no definitive way to prevent angle-closure glaucoma, there are several risk factors and preventive measures that can help reduce the risk:

Risk Factors:

1. Family history: If you have a family history of angle-closure glaucoma, you may be more likely to develop the condition.
2. Age: The risk of developing angle-closure glaucoma increases with age.
3. Asians: People of Asian descent are more likely to develop angle-closure glaucoma due to a narrower anterior chamber angle.
4. Eye shape: Certain eye shapes, such as a smaller eye or a more prominent iris, can increase the risk of developing angle-closure glaucoma.
5. Pseudophakia: Having had cataract surgery can increase the risk of developing angle-closure glaucoma.

Preventive Measures:

1. Regular eye exams: Regular eye exams can help detect signs of angle-closure glaucoma early on, when it is easier to treat.
2. Screening: Certain individuals, such as those with a family history of angle-closure glaucoma, may benefit from screening tests to detect potential problems.
3. Eye drops: Using eye drops to reduce intraocular pressure (IOP) can help prevent angle-closure glaucoma in individuals with a higher risk of developing the condition.
4. Monitoring: If you have a family history of angle-closure glaucoma or other risk factors, your eye care provider may recommend regular monitoring to detect any potential issues early on.
5. Surgery: In some cases, surgery may be necessary to prevent angle-closure glaucoma in individuals with a higher risk of developing the condition.
6. Laser iridotomy: A laser procedure that can be performed to create a small hole in the iris, allowing for better drainage of the eye and reducing the risk of angle-closure glaucoma.
7. Maintaining good eye health: Practicing good eye health by avoiding smoking, getting regular exercise, and maintaining a healthy diet can help reduce the risk of developing angle-closure glaucoma.

Other Tips:

1. Stay hydrated: Drinking plenty of water can help maintain proper eye pressure.
2. Avoid excessive caffeine and alcohol consumption: Both caffeine and alcohol can increase eye pressure and worsen symptoms.
3. Get regular exercise: Regular exercise can help reduce blood pressure and improve overall eye health.
4. Maintain a healthy weight: Obesity is linked to an increased risk of developing glaucoma.

By understanding the risk factors and taking preventive measures, you can reduce your risk of developing angle-closure glaucoma and protect your vision.