Angle Closure Glaucoma

Angle Closure Glaucoma

As the clocks have just gone back and the days are shorter, I have decided to do the next blog on angle closure glaucoma as this is more common in the winter months. 

Different Types of Glaucoma

There are two main types of glaucoma: open-angle and closed-angle glaucoma.

Open-angle glaucoma is the most common type of glaucoma in the UK. Eye pressure becomes high due to the drainage pathway (trabecular meshwork) not working well enough to drain the fluid that is produced.  Vision loss is often slow and painless so patients are not aware of the problem until the disease is already quite advanced.

Closed-angle glaucoma occurs when there is a blockage before the trabecular meshwork.  The eye is anatomically predisposed to this blockage as the front chamber of the eye is often small and shallow. People who often have narrow angles are those who are long-sighted (difficulty seeing near and sometimes distance), as well as those who have advancing cataracts that take up space in the front chamber of the eye.

What are the symptoms of an acute angle closure attack?

An acute angle closure attack occurs when the eye pressure rises rapidly. The first symptoms may be halos around lights or a general blurring of the vision. After this, there may be a dull ache around the eye or a generalised headache. If the intraocular pressure was to become very elevated then the pain in and around the eye can be very severe. 

How is angle-closure glaucoma treated?

Angle-closure glaucoma can be a medical emergency and prompt diagnosis and treatment is essential to prevent rapid vision loss. If you or anyone that you know has any of the symptoms listed above it is important to seek urgent medical care. Angle-closure attacks occur more frequently in dark conditions when the pupil is dilated and therefore further narrowing the drainage angles. It is for this reason that angle closure glaucoma attacks occur more frequently in the winter months and in the evening or nighttime.

The initial treatment for angle closure glaucoma is to lower the eye pressure with eye drops, tablets or sometimes an infusion of medication through the veins.

Definitive treatments.

To try and prevent a further angle closure glaucoma attack your eye doctor may suggest a laser procedure called a Yag peripheral iridotomy, where a tiny hole is made, using a laser, onto the iris (coloured part of the eye) to try and reduce the risk. The definitive treatment is to remove the lens, particularly if a cataract is present. Implanting a much thinner lens will result in much more space in the front chamber of the eye and cure the problem.

Prevention is better than cure.

As with many eye conditions, prevention is certainly better than cure and early diagnosis of eyes at risk of angle closure is essential to reduce this risk. Your optometrist or eye doctor will be able to tell you if you are at risk of angle closure glaucoma and refer you to a glaucoma specialist if required.

Although angle closure can be quite severe, thankfully the rates of angle closure attacks in the UK are quite low. On the other hand in other parts of the world, particularly the Far East, rates of angle closure are much higher as East Asian eyes are more predisposed to this condition.

If you have not had your eyes tested recently, I would advise you to get your eyes checked and continue to get them checked on a regular basis.

I hope that you find this information useful and please do feel free to share it with friends and family.  For more information please visit our website: www.innovationeyeclinic.co.uk/glaucoma  or contact us at info@innovationeyeclinic.co.uk or call 0800 005 3335.