Narrow Angle Glaucoma Treatment

Narrow-angle glaucoma, also called angle-closure glaucoma, is a serious eye condition that can lead to blindness if not treated immediately. According to The Glaucoma Foundation, narrow-angle glaucoma affects almost half a million people in the United States. Medication and surgery are the preferred treatment if you develop this form of glaucoma.

Types

• During an attack of acute narrow-angle glaucoma, the edges of the iris, the colored part of the eye, shift and block the eye's drainage canals. The drainage canals are located in the angle formed where the iris and cornea meet. The cornea is the clear layer covering the iris. When the drainage canals are blocked, pressure in the eye rises dangerously high. Increased pressure in the eye can damage the optic nerve, the connection between the eye and the brain, resulting in partial or full blindness if the condition is not treated. Sub-acute angle-closure glaucoma is a less severe form of narrow-angle glaucoma that may occur in a series of milder episodes. This form of narrow-angle glaucoma also requires prompt treatment to avoid loss of vision.

Symptoms

• Symptoms of acute narrow-angle glaucoma may include sudden, severe eye pain accompanied by a headache, blurred vision, red eyes, vomiting or nausea. Your pupils may become dilated and lights may appear to have halos around them. If you have sub-acute narrow-angle glaucoma, you may notice blurred vision or halos around lights but probably will not experience severe pain or redness in your eye. These symptoms may go away if the drainage channels clear on their own, but damage may be done each time you experience one of these episodes.

Medications

• Eye drops or oral or intravenous medications are used to reduce the pressure in your eye so that surgery can be performed to open the drainage channels. Medication is also used to increase drainage in the eye and reduce the amount of aqueous humor produced. The aqueous humor is a clear fluid that gives the eyeball its shape. This fluid constantly moves through the eye using the drainage canals. Reducing the amount of the aqueous humor produced helps prevent pressure inside the eye from increasing.

Surgery

• Iridotomy, a surgical procedure, is used to make new openings in the eye, allowing drainage of the aqueous humor. When drainage is restored, eye pressure drops and the iris returns to its usual position in the eye. Lasers are usually used to perform this surgery, although in some cases, traditional procedures using surgical incisions are needed. Laser gonioplasty may be performed to treat narrow-angle glaucoma or may be used in conjunction with iridotomy. During laser gonioplasty, small burns are made on the surface of the iris, causing the iris to contract and become flatter. When this occurs, the angle between the cornea and the iris opens, allowing drainage to occur.

Recovery

• Your eye pressure will be checked approximately 1 hour after you have had laser surgery and you will be asked to return during the next day to check your progress. Your doctor may instruct you to continue using eye medications for 1 or 2 days following treatment. If your eye is inflamed following surgery, corticosteroids can be used for several days to a week. During your follow-up examinations, your doctor will probably examine the angle of your other eye and schedule surgery in that eye if needed as a preventative measure.