An acute glaucoma, also referred to as angle-closure glaucoma, occurs when the drainage angle in the eye becomes blocked, resulting in sudden increases in intraocular pressure. An overview of acute glaucoma, including causes, symptoms, diagnosis, treatment, and prevention, is provided in this blog post.
Causes
In acute glaucoma, there is a sudden blockage of the drainage angle in the eye, preventing the aqueous humor (fluid) from draining properly. This blockage can be caused by:
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Individuals with narrow drainage angles in their eyes are more likely to develop acute glaucoma.
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In older individuals, the lens of the eye may become thicker with age, narrowing the drainage angle, increasing the risk of acute glaucoma.
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A family history of glaucoma increases the risk of developing it.
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In susceptible individuals, medications such as anticholinergics, antidepressants, and antihistamines can dilate the pupils and increase angle closure risk.
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Trauma to the eye or previous eye surgery can increase the risk of acute glaucoma and angle closure.
Symptoms
Acute glaucoma typically develops suddenly and may cause the following symptoms:
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Intense, throbbing pain in the eye or eyes affected by severe eye pain.
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Pain or pressure in the forehead or temples.
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In particular, vision may become blurry or cloudy around the edges.
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In low light conditions, you may see rainbow-colored halos around lights.
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Affected eyes may appear red or bloodshot.
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Depending on the intensity of the pain, some individuals may experience nausea or vomiting.
Diagnosis
In order to diagnose acute glaucoma, a comprehensive eye examination may be conducted, which may include the following tests:
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Tonometry measures intraocular pressure, which is typically elevated in acute glaucoma patients.
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Using gonioscopy, the healthcare provider can assess any blockages or abnormalities in the drainage angle.
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Ophthalmoscopy or imaging tests such as optical coherence tomography (OCT) can be used to assess the optic nerve's health and detect any damage.
Treatment
Glaucoma treatment aims to reduce intraocular pressure and alleviate symptoms as soon as possible. Options include:
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Low intraocular pressure may be treated with eye drops or oral medications such as miotics, beta-blockers, or carbonic anhydrase inhibitors.
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A laser peripheral iridotomy (LPI) reduces intraocular pressure and improves drainage by creating a small opening in the iris.
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To create alternative pathways for fluid drainage, surgical procedures such as trabeculectomy or goniotomy may be used in cases where other treatments are ineffective.
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Glaucoma patients experiencing severe eye pain may be treated with over-the-counter or prescription pain medications.
Prevention
Acute glaucoma can be prevented by early detection and management of risk factors. Some preventive measures include:
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Eye exams can help detect narrow angles or other risk factors for acute glaucoma before symptoms appear.
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Individuals at risk of acute glaucoma should avoid medications that dilate the pupils and increase intraocular pressure.
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Acute glaucoma complications can be reduced by managing underlying conditions such as diabetes and high blood pressure.
