Angle-closure glaucoma

Acute angle-closure glaucoma is an urgent but uncommon, dramatic symptomatic event with blurring of vision, painful red eye, headache, nausea, and vomiting.

Diagnosis is made by noting high intra-ocular pressure, corneal oedema, shallow anterior chamber, and a closed angle on gonioscopy.

Medical or surgical therapy is directed at widening the angle and preventing further angle closure.

If glaucoma has developed it is treated with therapies to lower intra-ocular pressure.

Chronic angle-closure glaucoma is diagnosed by noting peripheral anterior synechiae on gonioscopy, as well as progressive damage to the optic nerve and characteristic visual field loss. It is treated with therapies to lower intra-ocular pressure.

Angle-closure glaucoma (ACG) is a group of diseases in which there is reversible (appositional) or adhesional (synechial) closure of the anterior-chamber angle resulting in elevation of the intra-ocular pressure (IOP). The angle closure may occur in an acute or chronic form. In the acute form, the IOP rises rapidly as a result of relatively sudden blockage of the trabecular meshwork by the iris, via the pupillary block mechanism (mechanism that pushes iris from behind leading to angle closure). The chronic form may develop after acute angle closure where synechial closure of the angle persists. It may also develop over time, as the angle closes from prolonged or repeated contact between the peripheral iris and the trabecular meshwork, which often leads to peripheral anterior synechiae (PAS) and functional damage to the angle.