Narrow-Angle Glaucoma (Angle Closure Glaucoma)

Narrow-angle glaucoma is less common and is very different than open-angle glaucoma.  There are two main types of narrow angle glaucoma: acute and chronic.   In acute narrow angle glaucoma, the eye pressure suddenly increases to dangerously high levels.   This happens when the drainage canal is suddenly blocked.  There are many potential causes which result in blocking the drainage canal, including structual changes in the eye, scar tissue, and blood vessels.

 
The drainage canals get blocked or covered over
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Symptoms of narrow-angle glaucoma:

The onset of acute narrow-angle or anle closure glaucoma is typically rapid, constituting an emergency. If not treated promptly, this glaucoma produces blindness in the affected eye in three to five days. Symptoms may include:

• Inflammation and pain
• Pressure over the eye
• Moderate pupil dilation that's non-reactive to light
• Cloudy cornea
• Blurring and decreased visual acuity
• Extreme sensitivity to light
• Seeing halos around lights
• Nausea and/or vomiting

Causes of narrow-angle glaucoma:

• Defect in the eye structure
• Anything that causes the pupil to dilate -- dim lighting, dilation drops
• Certain oral or injected medications
• Blow to the eye
• Diabetes-related growth of abnormal blood vessels over the angle

Diagnosing narrow-angle glaucoma:

Everyone should be checked for glaucoma at around age 35 and again at age 40. Those considered to be at higher risk for narrow-angle glaucoma, including those who are Asian, farsighted or over the age of 60, should have their pressure checked every year or two.

Because of the rapid, potentially devastating results of narrow-angle glaucoma, you should seek medical treatment immediately if you experience any of the above symptoms.

During eye exams, your doctor will use tonometry to check your eye pressure. After applying numbing drops, the tonometer is gently pressed against the eye and its resistance is measured and recorded.	Tonometry is used to check your eye pressure
An ophthalmoscope or slit lamp biomicroscopy can be used to examine the shape and color of your optic nerve.   This magnifies the internal eye structures.   If the optic nerve appears to be cupped or is not a healthy pink color, additional tests will be run.	An ophthalmoscope is used to examine your optic nerve
Gonioscopy is used to determine whether the angle where the iris meets the cornea is open or closed, a key difference between open-angle glaucoma and narrow-angle glaucoma.	Goniscopy is used to help your glaucoma type

Treatment for narrow-angle glaucoma:

Laser iridotomy is a common treatment for narrow-angle glaucoma. During this procedure, a laser is used to create a small hole in the iris, restoring the flow of fluid to the front of the eye. In most patients, the iridotomy is placed in the upper portion of the iris, under the upper eyelid, where it cannot be seen.

Laser iridotomy

Filtration surgery is performed when medicines and/or laser surgery are unsuccessful in controlling eye pressure. During this microscopic procedure, a new drainage channel is created to allow fluid to drain from the eye.

Filtration surgery