Glaucoma
David Lotufo,
MD, answers questions about Angle Closure Glaucoma
Angle closure glaucoma, also known as acute glaucoma, is a less common form of
glaucoma. It is, however, more serious since it can cause
blindness in a short period of time.
Inside the eye is a fluid called the aqueous humor.
The aqueous humor flows from behind the iris and through the pupil. The eye constantly creates and drains this fluid. The drainage canal
is in the angle or space between the iris and the cornea. Once fluid
enters the canal, it is reabsorbed into the bloodstream.
As we get older, the lens of our eye becomes larger. This may narrow the
drainage space between the iris and the cornea. Occasionally
this space closes, leading to a rapid increase in pressure inside the
eye and a sudden loss of vision.
Be sure you know the symptoms of angle closure:
- if your eyes are red and painful
- if you have blurred vision
- if you see halos
- if you feel nauseous
You should seek emergency eye care immediately during the day
or night. Without prompt attention, blindness can occur within 24-48
hours.
What are the symptoms?
Symptoms are usually sudden and severe:
- blurred vision or a sudden loss of vision
- colored rings or halos around lights
- severe eye pain
- redness of the eye
- nausea and vomiting
- loss of side vision
Some people, however, have milder cases. Their symptoms may look like "pink
eye" (red eyes).
Who is at risk for this disease?
Most people with angle closure glaucoma have one or more of these features:
What is the treatment?
Immediate treatment may involve the use of pills, eye drops or other
medications to reduce the pressure and prevent eye damage.
Eventually, a new drainage canal is created in the iris using a painless laser
procedure called laser iridotomy. This office procedure
allows patients to continue their normal schedule the same day.
How can angle closure glaucoma be prevented?
A routine eye examination may identify patients with unusually narrow drainage
spaces, or angles, that are at risk of closing. These patients
may be treated with the laser procedure to prevent the development of
acute glaucoma.
Does laser iridotomy have side effects?
Some people have blurry vision after the procedure, but it doesn't last long.
Does laser iridotomy ever fail?
Yes, but rarely. laser iridotomy works 95% of the time. Sometimes, in
difficult cases, the eye doctor may have to do more than one treatment.
Will I miss a lot of work?
No, you will only need to take off the day of procedure. The treatment takes 10
minutes, but allow two hours. Your eye doctor will need time to check
your eye pressure before and after the procedure.
What if I choose not to have the laser iridotomy?
Be sure you know the symptoms of angle closure: if your eyes are red and painful,
if you have blurred vision, see haloes or feel nauseous, call our eye
doctor right away.
Dr. David
Lotufo, Glaucoma Specialist, practices in the Glaucoma Service
of Harvard Vanguard Medical Associates.
