Acute angle closure

There is a form of angle closure that is very aggressive and shows intense symptoms. In this condition, there is a sudden rise in pressure leading to severe eye pain (and around the eye), redness, decrease in vision. This is known as an acute attack of angle closure and represents a medical emergency, which, if not treated in time, can cause optic nerve damage and loss of vision.

Acute attack symptoms normally occur in one eye, but it may be present in both eyes at the same time. The duration of the symptoms is relatively long (hours), when both pain and decrease vision are often associated. The pupil is often mid-dilated, and the pupil reflex is unresponsive to light.

Episodes of isolated eye pain or isolated blurred vision (minutes) that resolve spontaneously are likely not an acute angle closure attack.

Treatment may include topical and systemic drugs to lower IOP, followed by laser treatment aimed to open the angle (See Laser peripheral iridotomy). In some cases, surgical procedures may also be used to treat this condition.

Acute angle closure Fig. 1

Fig. 1. Primary acute angle closure. Left – normal eye. Right - redness and mid-dilated pupil in an acute angle closure eye.

Acute angle closure Fig. 2

Fig. 2. Primary acute angle closure eyes, with mid-dilated pupil. Right image showing concomitant cataract.

World Glaucoma Association

Important message for glaucoma patients

It is important for you to get yourself regularly screened for glaucoma. If you have been diagnosed to have glaucoma, effective treatment options are now available and regular treatment and follow up can help you to preserve your vision for your lifetime, avoiding unnecessary fear of going blind.

You can live happily with glaucoma and enjoy an excellent quality of life, particularly if the disease is detected early and treated in time. Always remember that once you have glaucoma, you will have to be under the care of an eye doctor for the rest of your life.

There is a lot of research going on and new treatments may become available for glaucoma in the near future.

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