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 Acute Narrow Angle Glaucoma

How does acute narrow angle glaucoma occur?
What are the signs of acute narrow angle glaucoma?
How is this type of glaucoma treated?

Acute narrow angle glaucoma (also called angle closure glaucoma or narrow angle glaucoma) is one of the two basic categories of glaucoma. The other category is open angle glaucoma.

Although it affects less than 10 percent of patients with glaucoma, acute narrow angle glaucoma is the most serious form of the disease. The problem is often inherited and occurs more commonly in farsighted elderly people, particularly in women. It often occurs in both eyes. The chances of developing narrow angle glaucoma increase with age and are most prevalent in people in their 60s.

Glaucoma is a group of diseases that are distinguished by an increase in pressure inside the eye, which causes damage to the optic nerve and to the retina (See Anatomy of the Eye.). Like the film in a camera, a healthy retina receives light rays from the front of the eye and transmits them through the optic nerve to the brain where they are turned into images. Damage to the retina or the optic nerve can result in serious vision loss and even blindness if not detected and treated early. Glaucoma is one of the most common causes of preventable vision loss.

How does acute narrow angle glaucoma occur?

Acute narrow angle glaucoma occurs primarily in patients who have a shallow space between the cornea at the front of the eye and the colored iris that lies just behind the cornea. As the eye ages, the natural lens behind the pupil grows and the pupil becomes smaller, restricting the flow of fluid to the drainage site. Fluid can build up behind the iris, pushing it forward and blocking the channel (angle) that normally allows aqueous fluid to drain. If blockage happens, a rapid rise in intraocular pressure can occur.

Diabetes can be a contributing cause to the development of glaucoma.

What are the signs of acute narrow angle glaucoma?

Narrow angle glaucoma is usually very painful because of the sudden increase in pressure inside the eye. In some cases, when the drainage angle is only partially or temporarily blocked, there can be warning attacks such as blurry vision and the appearance of colored halos around lights. Warning attacks can also include severe pain and redness. If the drainage angle is completely blocked, an acute attack will almost certainly develop.

The symptoms of an acute attack are more severe and can be totally disabling. They include severe pain, often accompanied by nausea and vomiting. An acute attack should always be treated as a medical emergency. If the symptoms occur, call your eye doctor at once, or go to the emergency room if you are unable to contact your physician. Vision may be preserved or serious damage may be avoided by prompt treatment.

How is this type of glaucoma treated?

The treatment for this type of glaucoma is known as a peripheral iridectomy. This is a laser procedure that creates a new opening in the iris to allow the aqueous fluid to move more easily to the drainage site. The peripheral iridectomy is usually performed in the doctor's office and is generally performed on both eyes because the risk of developing the condition in both eyes is high.

If caught at an early stage and properly treated, narrow angle glaucoma can be controlled. If not treated promptly, optic nerve damage can occur and other parts of the eye may develop secondary types of glaucoma.

Patients who are at high risk for developing narrow angle glaucoma should be aware that certain medications, including some that are nonprescription, may increase the risk for developing glaucoma. Read the package warning carefully. If you have a family history of farsightedness and/or acute angle closure glaucoma, be sure to visit your eye care professional regularly.

Related topics:

See Eye Exam Types in Eye Health Center.
See Free Eye Tests.

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