Angle-Closure Glaucoma: Symptoms and Treatments

Angle-closure glaucoma is a serious eye condition that can lead to significant vision loss if not diagnosed and treated promptly. Unlike open-angle glaucoma, angle-closure glaucoma occurs when the drainage angle of the eye becomes blocked, leading to a sudden increase in intraocular pressure. This can cause severe symptoms and requires immediate medical attention. 

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What is Angle-Closure Glaucoma?

Angle-closure glaucoma, also known as closed-angle glaucoma, is a type of glaucoma characterized by a rapid or gradual closure of the drainage angle of the eye. This closure prevents aqueous humor, the fluid inside the eye, from draining properly, leading to increased intraocular pressure. This pressure can damage the optic nerve, resulting in vision loss.

Angle-Closure Glaucoma vs. Open-Angle Glaucoma

Understanding the difference between angle-closure glaucoma and open-angle glaucoma is crucial. While both conditions involve increased intraocular pressure, their mechanisms and symptoms differ. Open-angle glaucoma develops slowly over time and is often asymptomatic in the early stages. In contrast, angle-closure glaucoma can occur suddenly and is considered a medical emergency.

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Causes of Angle-Closure Glaucoma

The causes of angle-closure glaucoma are linked to the anatomical structure of the eye. Factors that can lead to the development of this condition include:

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Recognizing the Symptoms

The symptoms of angle-closure glaucoma can vary depending on whether the onset is acute or chronic. Acute angle-closure glaucoma presents with sudden symptoms that may include:

Chronic angle-closure glaucoma may progress silently with gradual vision loss and intermittent symptoms. Recognizing these symptoms early is vital for preserving vision.

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Diagnosis of Angle-Closure Glaucoma

Timely diagnosis of angle-closure glaucoma is essential to prevent permanent vision loss. The diagnostic process involves several steps:

Comprehensive Eye Examination

A thorough eye examination by an ophthalmologist is the first step in diagnosing angle-closure glaucoma. This exam will include measuring intraocular pressure, assessing the angle of the eye, and checking for optic nerve damage.

Gonioscopy

Gonioscopy is a specialized test that allows the eye doctor to view the angle of the eye directly. It helps determine whether the angle is open or closed and assess any anatomical abnormalities.

Optical Coherence Tomography (OCT)

OCT is a non-invasive imaging test that provides detailed images of the eye's structures. It can help detect any changes or damage to the optic nerve and retina, crucial for diagnosing glaucoma.

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Treatment Options for Angle-Closure Glaucoma

The treatment for angle-closure glaucoma aims to reduce intraocular pressure and prevent further optic nerve damage. The specific approach depends on the severity of the condition and the underlying causes.

Medications

In acute cases, medications are used to quickly lower intraocular pressure. These may include oral medications, eye drops, or intravenous medications to reduce fluid production or increase fluid outflow.

Laser Therapy

Laser peripheral iridotomy is a common procedure used to treat angle-closure glaucoma. It involves creating a small hole in the peripheral iris to improve fluid drainage and relieve pressure.

Surgical Interventions

In some cases, surgical procedures may be necessary to create an alternative drainage pathway. These procedures aim to prevent future episodes of angle closure and preserve vision.

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Managing Angle-Closure Glaucoma

Effective management of angle-closure glaucoma involves ongoing monitoring and lifestyle modifications to prevent further episodes and protect vision.

Regular Eye Examinations

Regular follow-up appointments with an ophthalmologist are crucial for monitoring intraocular pressure and optic nerve health. Early detection of any changes can lead to timely interventions.

Lifestyle Modifications

Patients are advised to avoid medications that can dilate the pupils, such as certain over-the-counter cold and allergy medications. Staying hydrated and maintaining a healthy lifestyle can also help manage the condition.