Angle-closure glaucoma can manifest as either an acute or chronic condition, characterized by increased pressure in the eye's anterior chamber. This pressure results from either a sudden (acute) or gradual (chronic) obstruction of the normal drainage of fluid. The blockage typically occurs at the angle formed where the iris meets the cornea. People with naturally narrow angles, particularly those of Asian or Eskimo descent, are more susceptible. Other risk factors include age and family history. This condition is more prevalent among older women. When the pupil is fully dilated, the iris thickens and retracts, potentially obstructing the canal of Schlemm, which is responsible for fluid drainage. This blockage leads to increased intraocular pressure. In acute angle-closure glaucoma, there is a rapid pressure rise as fluid accumulates in the eye. This can damage the optic nerve, possibly resulting in blindness. Early detection of elevated pressure is crucial before symptoms appear.If acute angle glaucoma symptoms do occur, they might include intense eye and facial pain, nausea, vomiting, reduced and blurred vision, and seeing halos around lights. In severe cases, the eye appears red, with a cloudy cornea and a non-reactive, fixed, and dilated pupil. Acute angle-closure glaucoma is an emergency, as optic nerve damage and vision loss can happen within hours. The first step in treatment is administering medications to reduce eye pressure. Historically, an iridectomy was performed to remove a piece of the iris and create an alternative fluid drainage pathway. Nowadays, a similar procedure can be done with a laser to create a small hole in the iris, maintaining normal pressure levels. This condition can progress slowly as chronic angle-closure glaucoma or occur suddenly as acute glaucoma. Like the more common open-angle glaucoma, chronic angle-closure glaucoma can cause vision loss without noticeable symptoms.
