Glaucoma is a condition, often associated with raised intraocular pressure, which can result in damage to the optic nerve affecting the field of vision. The level of intraocular pressure depends on the balance between the rate at which aqueous fluid is produced within the eye and the rate at which it leaves through the drainage angle of the eye. Angle closure glaucoma occurs when the eye’s drainage angle becomes blocked, causing the intraocular pressure to increase, sometimes suddenly and painfully.
Some people are born with narrow drainage angles and are predisposed to primary angle closure glaucoma (PACG).
Risk factors for acute angle closure glaucoma include: female, Asian, long-sighted, older age. There is usually a history of headaches, eye pain & blurred vision.
Secondary angle closure glaucoma can be caused by a big cataract (phacomorphic glaucoma) in a small (hypermetropic) eye. Other causes include trauma and intraocular surgery.
The symptoms of angle closure glaucoma depend on the cause and suddenness of the increase of intraocular pressure:
If the drainage angle of an eye closes then the drain becomes completely blocked, the intraocular pressure suddenly rises (acute angle closure) causing pain, halos, blurring of vision and nausea – this is an emergency and requires immediate treatment.
Most people with chronic primary angle closure have no symptoms.
Increasing pressure can damage the optic nerve initially affecting peripheral vision.
Driving may become more difficult, only noticing hazards when they are in the centre of the field of vision.
The lack of obvious symptoms highlights the importance of regular eye checks, by optician or ophthalmologist, to detect increased intraocular pressure, reduced field of vision and narrow drainage angles.
Elevated intraocular pressures can be controlled by:
Either a single drop or a combination of drops
Only occasionally used for short term therapy
YAG Laser Iridotomy
Cataract surgery alone, Minimally Invasive Glaucoma Surgery (MIGS), Trabeculectomy, Filtration (Tube) Surgery
