Acute Angle Closure Glaucoma

Acute angle closure glaucoma is a rapid or sudden increase in intraocular pressure (IOP), the pressure inside the eye. Acute angle closure glaucoma is an uncommon form of glaucoma, but one that can cause permanent vision loss if you do not seek treatment immediately. Unlike other forms of glaucoma, the symptoms of acute angle closure glaucoma develop suddenly:

Symptoms

  • Eye pain and/or headache
  • Pain over eyebrow area (can be confused with sinus pain)
  • Decreased vision
  • Pupils dilated and/or pupils are different sizes
  • Red eye
  • Nausea and/or vomiting
  • Halos or rainbows around lights

If you experience two or more of the symptoms listed above, you should seek treatment at an emergency room immediately. Immediate treatment is necessary to relieve symptoms and prevent loss of vision.

The pain experienced during an acute attack is due to the build-up of a fluid known as aqueous humor within the eye. If the channels within the eye that normally drain the aqueous humor become blocked or otherwise fail to function properly, fluid levels build up, increasing the intraocular pressure within the eye. Although most often acute attacks affect only one eye, occasionally both eyes are affected.

Risks

  • Certain populations are at higher risk for an acute angle closure glaucoma attack. They include:
  • People of East Asian or Inuit descent who are ages 50 – 80
  • People ages 60 – 80
  • People who have farsightedness
  • People who have previously had symptoms of acute angle closure glaucoma
  • People with a close relative (mother, father, sister or brother) who has had acute primary angle closure glaucoma

Treatment

The immediate treatment for acute angle closure glaucoma is to reduce the intraocular pressure as quickly as possible. Several medications can be used to reduce eye pressure, and they are usually delivered via eye drops. Once the intraocular pressure is lowered, laser surgery is used to create a small hole in the iris that allows the aqueous humor to flow freely between the front part of the eye and the area behind the iris. This procedure is called an iridotomy.

Iridotomy is usually advised for the other eye so as to prevent acute angle closure glaucoma from developing (which is otherwise quite likely). Eye drops may also be prescribed to help keep your eye pressure at appropriate levels. 

In general, surgery for acute angle closure glaucoma is successful and long lasting. It is still important to get regular checkups after an episode of acute angle closure glaucoma because a chronic form of glaucoma may still occur.