Closed Angle Glaucoma is a sudden large increase in the intra ocular pressure of the eye. It can be triggered by anything that dilates the eye, including dilating drops, dim lighting, and certain medications. Usually it is sudden, but some forms can be prolonged.
Typically this is caused by one or more of the following reasons:
- Pupillary Block. Eye fluid known as the aqueous flows easily through the pupil into the front of the eye. But if the back of the iris adheres to the lens inside the eye, this pupillary channel becomes blocked. Then fluid backs up behind the iris, pushing the iris forward until it closes the drainage angle in the anterior chamber.
- Iris Plateau. In this condition, the iris is attached to the ciliary body too close to where drainage occurs. When the pupil dilates, the iris tissue bunches up in the drainage angle, causing pressure to rise quickly. This type of narrow-angle glaucoma attack can occur in conditions when the pupil dilates in dim lighting or when eye drops are used to intentionally enlarge the pupil during an exam.
- Hyperopia. People who are farsighted are more likely to have eyes with shallow anterior chambers and narrow angles, increasing their risk for angle-closure glaucoma from pupil dilation or aging changes in the eye.
- Tumors and Other Causes. A tumor behind the iris, and alteration of the shape of the eye after surgery for a detached retina also can cause angle-closure glaucoma.
Patients typically complain of a very sudden, sharp pain with light sensitivity, a very painful headache accompanied with nausea as well as very blurry vision. Upon examination, the eye is very red and inflamed, the intraoular pressure is very high and the cornea looks cloudy.
Those with open angle glaucoma, those who have anatomy with narrow angles, Asians, African Americans, those who are far sighted and over 60 years of age all play risk factors in developing closed angle glaucoma.
The primary treatment is a laser treatment known as Laser Peripheral Iridotomy(LPI) which makes a small hole in the iris, allowing it to fall back from the fluid channel, helping the fluid drain. Sometimes this is used in conjunction with oral medication and eye drops to help immediately lower the eye pressure. Many times, even though the angle closure is only in one eye, the doctor will treat both eyes as a safety precaution.
This type of glaucoma demands immediate medical attention. If you are having any of these symptoms, call our office right away, or go to the emergency room. If the Intraocular pressure remains abnormally high for long periods of time, optic nerve damage can occur, causing permanent vision loss.