GLAUCOMA, PRIMARY ANGLE-CLOSURE

General Information

DEFINITION--A condition of the eye in which the fluid that normally drains into and out of the eye is gradually obstructed and the pressure of the fluid becomes abnormally high. This causes damage to the optic nerve and loss of vision. Angle-closure glaucoma can occur in subacute, acute (which is an emergency) and chronic forms.

BODY PARTS INVOLVED--Eye.

SEX OR AGE MOST AFFECTED--Adults ages 55-70, women more than men.

SIGNS & SYMPTOMS

Acute:

• Severe, throbbing eye pain and headache.
• Redness in the eye.
• Blurred vision or halos around lights.
• Tender, firm eyeball.
• Dilated, fixed pupil.
• Swollen upper eyelid.
• Vomiting and weakness (due to severe eye pain).

Subacute:

• Symptoms may be mild and intermittent. They may occur while watching TV or movies in a dark room and be relieved by sleep or rest.
• Dull ache in or around one eye.
• Mildly blurred vision.

Chronic:

• May be no symptoms.
• Symptoms may be similar to subacute form.

CAUSES--Precise cause is unknown.

RISK INCREASES WITH

• Adults over 60.
• Family history of glaucoma or farsightedness.
• Use of certain medications with cholinergic inhibition.
• Cataracts.

HOW TO PREVENT--Consult your doctor regularly for checkups to detect glaucoma before symptoms begin. If you are over 40, have pressure inside the eye checked at least once a year. The test is simple and painless.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies such as tonometry (measurement of pressure within the eyeball).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for the acute form during the attack. Various treatments (pills, liquids, intravenous fluids) are given to try and reduce the very high eye pressure.
• Surgery (iridectomy with laser beam) to prevent further attacks if other treatment is unsuccessful. A small opening is made in the periphery of the iris so that the aqueous humor (fluid in the eye) can drain. This may control the attack, but medications may still be necessary to control the pressure.

POSSIBLE COMPLICATIONS--Total blindness in the affected eye, if treatment is delayed or unsuccessful.

PROBABLE OUTCOME--Symptoms can be controlled if treatment begins quickly.

How To Treat

GENERAL MEASURES--

• Avoid emotional upset, which raises pressure in the eye.
• Don't smoke. Tobacco constricts blood vessels, reducing the blood supply to the eye.
• Follow your doctor's instructions.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Eye drops to lower pressure inside the eye. Follow the instructions and schedule carefully, even if symptoms subside or the eye drops are occasionally uncomfortable.
• Diuretics to decrease fluid pressure in the eye.
• Pain relievers.

ACTIVITY--After treatment, resume your normal activities gradually--but avoid fatigue. Resume sexual relations when eye pressure is under control.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of glaucoma. Acute glaucoma is an emergency!
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.