There are actually two types of Angle Closure Glaucoma: Primary Angle Closure Glaucoma and Acute Angle Closure Glaucoma. Even though Angle Closure Glaucoma is not nearly as common as Open Angle Glaucoma, it is worth understanding as it can cause significant vision loss is short timeframes.
Acute Angle Closure Glaucoma is one of the only types of Glaucoma that produce distinct symptoms that include pain, light sensitivity, redness, blurred vision, colored haloes around lights and nausea or vomiting.
With Angle Closure Glaucoma, the Trabecular Meshwork, can become obstructed or even completely blocked by folds of the Iris bunching up over the meshwork. This can actually happen if the size or shape of the tissue adjacent to the drainage meshwork is altered so that when the pupil dilates, perhaps in a darkened room, there is a sudden and considerable rise in Intraocular Pressure. In situations where the meshwork becomes blocked abruptly, it will cause a sudden rise in the Intraocular Pressure (IOP), resulting in Acute Angle Closure Glaucoma. Angle Closure Glaucoma in a sudden rise in pressure which will can cause pain, redness, blurred vision and if left untreated permanent loss of vision.
Generally, Angle Closure Glaucoma, results from anatomical changes within the internal structures of the eye. Angle Closure Glaucoma is occurs more often in farsighted eyes, which tend to be smaller and in patients between the ages of 45-60 years of age where the Crystalline Lens is beginning to swell.
As part of your routine eye examination, Drs. Alterman, Modi and Wolter will observe the “chamber angle” and if it appears to be narrowed, will perform an additional examination procedure called Gonioscopy. This allows them to directly visualize the meshwork and the angle in order to carefully assess your predisposition to Angle Closure Glaucoma. Gonioscopy is not uncomfortable, takes just a few minutes and is performed by using a special contact lens that is gently placed on the eye.
Should Drs. Alterman, Modi or Wolter find that you are either at risk for Angle Closure Glaucoma or actually have Angle Closure Glaucoma, they may first prescribe some medication to lower the Intraocular Pressure (IOP) and will most likely need to perform a laser treatment to produce a small opening in the Iris so that Aqueous Humor can quickly and efficiently drain from the eye. This procedure, performed right in the office, is called a Laser Iridotomy, and is quite successful in treating Angle Closure Glaucoma and preventing it from recurring.
