Acute Angle Closure Glaucoma | Ophthalmology | Loyola Medicine

Acute Angle Closure Glaucoma

Overview and Facts about Acute Angle Closure Glaucoma

Acute angle closure glaucoma occurs when there is a sudden rise in intraocular pressure, the pressure inside the eye. This is caused by a buildup of fluid in the eye. Normally, fluid drains out of the eye through a channel called the angle that runs between the cornea and the iris. In cases of acute angle closure glaucoma, the iris presses against the angle, closing it off and preventing fluid from being released.

Acute angle closure glaucoma is one of the least common glaucoma conditions, accounting for less than 10 percent of all cases.

Signs and Symptoms of Acute Angle Closure Glaucoma

Symptoms of acute angle closure glaucoma appear quickly, as the condition can manifest in just a few hours. They include:

  • Extreme eye pain
  • Pupils that are different sizes
  • Extreme headaches
  • Blurry vision or complete loss of sight
  • Vomiting or nausea
  • Redness in the whites of the eyes
  • Seeing halos or rainbows when looking into lights

Often, only one eye is affected at a time, and symptoms tend to worsen as time goes on.

Causes and Risk Factors of Acute Angle Closure Glaucoma

The main cause of acute angle closure glaucoma is the iris pushing against the eye’s drainage system. This can happen when your pupils dilate too quickly, such as when you:

  • Go from a very bright environment to a very dark environment
  • Become overly excited
  • Get special eye drops for dilation
  • Take specific drugs known to affect dilation, such as antihistamines or antidepressants

There are also some diseases that can lead to acute angle closure glaucoma, which include:

  • Tumors
  • Diabetic retinopathy
  • Cataracts
  • Ectopic lens
  • Uveitis
  • Ocular ischemia

Overall, acute angle closure glaucoma is three times more likely to occur in women than men. It is also more likely to occur in Asians or Eskimos due to the narrower angle in their eyes.

Tests and Diagnosis of Acute Angle Closure Glaucoma

If acute angle closure glaucoma is suspected, your ophthalmologist will immediately conduct a number of tests to confirm a diagnosis, as it’s imperative to treat this condition right away to prevent permanent damage to vision. Tests conducted might include:

  • Ophthalmoscopy, which is when the doctor looks at your optic nerve with a light
  • Gonioscopy, which is when your doctor uses a microscope with a light to see if fluid is draining
  • Tonometry, which is how the doctor measures your intraocular pressure

Treatment and Care for Acute Angle Closure Glaucoma

Treatment for acute angle closure glaucoma consists of first getting the pressure down inside your eye. The doctor will do this by applying eyedrops or administering medication.

After the pressure is stabilized, your doctor will perform surgery to re-open the angle. The two types of surgery are:

  • Laser iridotomy, which is when the doctor makes a hole in your iris to create a pathway for fluid
  • Laser iridoplasty, also known as gonioplasty, which is when your doctor pulls the iris away from the drainage canal