SRINAGARIND MEDICAL JOURNAL

Volume 35, No. 06, Month NOVEMBER, Year 2020, Pages 777 - 783

Acute angle closure glaucoma

Sukhumal Thanapaisal, Pawasoot Supasai

Abstract Download PDF

Acute angle-closure glaucoma is an ocular emergency that potentially leads to irreversible blindness if the treatment is delayed. The main etiology is the iridotrabecular contact, resulting in anterior chamber angle closure and inadequate drainage of aqueous humor hence the intraocular pressure (IOP) suddenly increases. Risk of angle closure is high among the elderly, women, Asian population and those with hyperopia. Diagnosis relies on history of symptoms resulting from the acute IOP rising and ocular examination demonstrating angle closure with anatomical risk factors. Patients usually present with acute severe painful blurred vision, ciliary injection, seeing rainbow halo around lights, nausea, vomiting and headache. Ocular examination shows high IOP, shallow anterior chamber, anterior lens position, closed anterior chamber angle, and occasionally, optic disc edema. Treatment consists of immediate IOP reduction, control of inflammation and reopen the angle by laser or lens extraction with goniosynechialysis. Serial gonioscopy is considered for the long-term angle monitoring. Trabeculectomy is performed in cases of uncontrolled IOP after reopening of the angle.

Keywords

angle-closure glaucoma; acute angleclosure glaucoma; ocular emergency

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