Glaucoma Narrow Angle

GLAUCOMA is a disorder of the optic nerve associated with changes in the appearance of the optic nerve head, specific visual field changes. Glaucoma is fairly common over the age of 35, affecting 2 of every 100 persons.  It also occurs in younger age groups, but with much less frequency.

 

Angle-Closure glaucoma, also referred to as narrow angle or closed angle glaucoma, is a grouping of several forms of glaucoma which all share the common aspect of a narrow or obstructed drainage angle in the eye.  Angle-closure glaucoma is less common than open angle glaucoma.  Whereas open angle glaucoma is more common in near sighted persons, angle-closure glaucoma is more common in farsighted persons. The treatment, symptoms and management of these two glaucoma categories are also quite different.

 

Most patients have NO SYMPTOMS when first diagnosed. The different types of angle-closure glaucoma are:

 

  • INTERMITTENT ANGLE-CLOSURE GLAUCOMA causes no symptoms and slowly damages the nerves.  This form of glaucoma may damage the nerves at nighttime and/or in certain situations, with the intraocular pressures remaining apparently normal during daytime eye exams.  Late in the disease process the intraocular pressures may become elevated.  Regular comprehensive eye examinations can diagnosis this disease early and prevent loss of sight.

  • CHRONIC ANGLE-CLOSURE GLAUCOMA causes no symptoms may progress moderately if left untreated.  This is the most common kind of angle-closure glaucoma.

  • ACUTE ANGLE-CLOSURE GLAUCOMA can occur at any age and is a true medical emergency.  Symptoms may include any of: rainbow-like halos/circles around lights, severe pain in the eyes and/or forehead, headaches, nausea, and/or blurred vision.  Immediate professional care is needed to preserve sight since blindness can occur quickly in a day or two without treatment.

  • SECONDARY ANGLE-CLOSURE GLAUCOMA can be caused by cataracts, trauma or infections/inflammations.  In certain cases, this type of angle-closure can sometimes be cured by removing or controlling the offending cause.

 

Some types of angle-closure glaucoma cannot be cured.  Treatment is directed at controlling the disease in order to preserve vision.  Therapies may include glaucoma drops, laser therapy and/or glaucoma surgery.  Control is a matter of reducing intraocular pressure down to a level tolerated by the eye.  Control is manifest in stable pressures, stable visual fields and stable appearance of the optic nerve heads.  Good glaucoma management consists of the vigilant and frequent monitoring of these three factors.  This is why patients with glaucoma should be reexamined every 3 to 4 months for the rest of their lives.  Glasses need to be updated in glaucoma patients just as in the normal population.

 

Patients who have angle-closure glaucoma, or whom are suspects, should avoid, when practical, any prescription medications that are contraindicated for glaucoma patients, such Topiramate, scopolamine motion sickness patches and bladder/GI muscle control medications.  Non-prescriptions drugs of particular concern are cold medications, anti-histamines (Benadryl, Tylenol PM), stimulants, sinus decongestants, motion sleekness (Dramamine) and sleep aids (Unisom, doxylamine, trazodone).  With regular eye exams and careful management, the outlook is bright for almost all patients with this disease.