Angle-closure glaucoma (ACG) is a complicated disease / group of eye diseases that damage the optic nerve.
The optic nerve transfers visual information from the eye to the brain and if it’s damaged, it can result in sight loss and even blindness.
Angle-closure glaucoma occurs when the drainage angle and trabecular meshwork inside the eye becomes obstructed due to a shallow angle between the iris and cornea.
In the acute setting (acute angle closure glaucoma) this leads to a sudden and significant rise in intraocular pressure which can damage the optic nerve in a few hours.
It can also develop more slowly (chronic angle closure glaucoma) with no symptoms initially, so patients are unaware until the damage is severe or they have an attack of acute angle closure. One out of three people (30%) with chronic angle-closure will have a sudden episode of acute angle closure.
What are the Symptoms?
What are the Causes?
Some patients have a greater risk of developing ACG including: those with family history of glaucoma, people with shallow angle anatomy / plateau iris configuration, dilating eye drops / antidepressant medications, advanced / mature cataracts, ocular ischaemia, people who are very hypermetropic, people over age 40, people who have diabetes or high blood pressure, African-Americans and Hispanics, people who take long-term steroid medications and people who have had eye injuries or surgery.
What is the Diagnosis?
Glaucoma is diagnosed by measuring the intraocular pressure using a Goldman applanation tonometer in conjunction with measurement of the central corneal thickness. Patients at risk of angle-closure need full gonioscopic examination of the angle and assessment of the anterior chamber parameters using an anterior segment OCT.
Glaucoma is the presence of an elevated intraocular pressure in conjunction with damage to the optic nerve and visual field loss. The visual field is assessed using a Humphrey Visual Field Analyser and the optic nerve via OCT and RNFL assessments.
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