Acute Angle-closure Glaucoma is an uncommon type of Glaucoma, that affects approximately 1 in 1,000 people worldwide. It is more common in older individuals, particularly those over the age of 40.

Despite its rarity, this condition is a medical emergency. If not treated, it may lead to permanent vision loss and other severe consequences.

In this article, we will learn about Acute Angle Closure Glaucoma, its symptoms, causes, and ways to manage this rare condition. 

Defining Acute Angle Closure Glaucoma

Acute Angle-closure Glaucoma (AACG) is a rare yet severe type of Glaucoma characterized by a sudden and intense obstruction of the eye’s drainage canals. This results in a swift increase in intraocular pressure (IOP).

The blockage happens between the front part of the eye (anterior chamber) and the space between the iris and the lens (posterior chamber). This blockage causes a pressure change, which then changes the shape of the iris. This condition can sometimes result in vision changes or even blindness. 

Symptoms of Acute Angle-closure Glaucoma

Recognizing the symptoms of AACG is crucial to ensuring timely treatment and preventing long-term damage to the eye. The following are the symptoms of AACG:

  • Eye pain
  • Severe headache
  • Nausea or vomiting
  • Very blurry or hazy vision
  • Redness in the white part of the affected eye (Sclera)
  • Pupils of different sizes
  • Sudden loss of sight
Warning:
If the symptoms of Acute Angle-closure Glaucoma are not treated, it can lead to permanent vision loss. Immediate medical attention is crucial to prevent severe complications.

Causes

A woman squeezing her eyes in pain
A woman squeezing her eyes in pain

The following are the causes of Acute Angle-closure Glaucoma:

Relative pupillary block

Relative pupillary block is the most common cause of AACG. This condition occurs when the pupil dilates excessively, causing the iris to press against the eye’s drainage canals and obstruct fluid outflow. If not treated promptly, the sudden increase in IOP can cause severe pain and vision loss.

Plateau iris syndrome

Plateau Iris Syndrome is a condition where the iris has a flat, plateau-like shape that can block drainage canals in the eye. This can cause AACG, especially when the pupil dilates. People with this condition often need careful monitoring and may require surgery to prevent further episodes.

Enlarged or anteriorly displaced lens

Acute Angle-closure Glaucoma can result from an enlarged or anteriorly displaced lens. With age, the lens naturally thickens, potentially pushing the iris forward and obstructing drainage channels in the eye. This blockage leads to a sudden increase in intraocular pressure.

Cataracts

Cataracts, a clouding of the lens, can cause the lens to become enlarged. This enlargement can press against the iris and obstruct the drainage canals, leading to AACG.

Ectopic lens

An ectopic lens that has moved from its normal position can block the drainage canals and cause AACG. This displacement can result from trauma, congenital conditions, or degenerative changes. 

Diabetic retinopathy

Diabetic retinopathy, a complication of Diabetes, can damage the blood vessels in the eye, leading to the formation of scar tissue and abnormal blood vessels. These changes can block the drainage canals, causing AACG. Managing Diabetes and monitoring eye health is essential to prevent this severe complication.

Fact
In 1862, Franciscus Cornelis Donders discovered that high intraocular pressure caused blindness, naming the disease “Glaukoma simplex.” The diagnosis of Glaucoma advanced with the invention of the tonometer and perimeter and the introduction of cocaine.

Treatment options

The treatment options for AACG are aimed at reducing IOP, suppressing inflammation, and reversing the angle closure.

Medical treatment

Medical treatment for AACG typically begins with the administration of Acetazolamide, a topical beta-blocker, and a topical steroid. Acetazolamide is given as a stat dose of 500 mg IV followed by 500 mg, while a topical beta-blocker such as Carteolol or Timolol is used to lower IOP. 

An alpha-agonist may also be added to decrease IOP further. Topical steroids are used to decrease the inflammatory reaction and reduce optic nerve damage.

Laser treatment

Laser treatment is the definitive treatment for AACG. The most commonly used laser treatment is Laser Peripheral Iridotomy (LPI), which creates an opening in the iris to allow aqueous humor to flow through. 

This procedure is usually performed 24-48 hours after IOP is controlled. Other laser treatments include Argon Laser Peripheral Iridoplasty (ALPI) and Anterior Chamber Paracentesis (ACP).

Surgical treatment

Surgical treatment for AACG includes corneal indentation (CI), a temporary method to lower IOP until permanent treatment can be provided. CI works by pressing on the cornea to push aqueous humor to the edge of the anterior chamber, temporarily opening the angle and reducing IOP.

You can also consider using Travatan 2.5ml (0.004%) and Careprost 3ml of 0.03% eye drops, both offered at WowRx. These treatments effectively address elevated eye pressure associated with Glaucoma.

Conclusion

Acute Angle-Closure Glaucoma (AACG) is a rare yet serious eye condition requiring immediate medical attention to prevent vision loss. It arises from a sudden blockage in the eye’s drainage canals, leading to a rapid increase in intraocular pressure (IOP).

AACG symptoms include eye pain, severe headaches, nausea, and sudden vision loss. Factors causing this condition could be relative pupillary block, plateau iris syndrome, and lens issues.

Treatment involves rapidly lowering IOP with medications and, in severe cases, laser procedures such as Laser Peripheral Iridotomy. Regular monitoring and quick action by an ophthalmologist are vital to prevent complications and protect eyesight.

Frequently Asked Questions

What causes Acute Angle Closure Glaucoma?

Acute Angle-closure Glaucoma occurs when the eye’s drainage canals become blocked. Risk factors include smaller eye size, being female, far-sightedness, advanced age, and a family history of the condition. Certain medications can also trigger it.

How serious is Acute Angle Closure Glaucoma?

Acute angle-closure Glaucoma is a highly serious condition. Without immediate treatment, it may lead to permanent vision loss. Symptoms include severe eye pain, headaches, nausea, and blurred vision. Timely medical intervention is crucial to prevent severe complications associated with this condition.

How long does Acute Angle-closure Glaucoma last?

Acute Angle-closure Glaucoma typically lasts for several hours to a few days if treated promptly. Without treatment, symptoms can persist and lead to permanent vision loss. Immediate medical attention is crucial.

Can Acute Angle-closure Glaucoma be cured?

While Acute Angle-closure Glaucoma can be effectively treated, it is not always curable. Treatment aims to reduce intraocular pressure and prevent optic nerve damage using medications, laser therapy, or surgery. Regular monitoring and follow-up care are essential for preserving vision.

Can stress cause Acute Angle-closure Glaucoma?

In some cases, stress can trigger Acute Angle-closure Glaucoma by causing pupil dilation. This can worsen the condition for those prone to it. If you experience symptoms like eye pain or blurred vision, seek immediate medical help.

Citations:
WowRx uses only high-quality sources while writing our articles. Please read our content information policy to know more about how we keep our content reliable and trustworthy.