Narrow Angle Glaucoma

Optic nerve consists of many nerve fibers arranged like a cable. Just like many small wires in a big cable, the image that the eye sees is sent to the brain by way of these fibers. When the fibers are damaged by glaucoma, the eye will have a corresponding blind spot, and when enough of these fibers are lost, the eye can become blind.

The most common glaucoma in the United States is open angle glaucoma, but Asians have a higher than normal risk of a different type, called angle-closure glaucoma. There is a normal pathway for the fluid in the eye to flow in, and also drain out. When the inflow of fluid is greater than the outflow, pressure can build within the eye, and create glaucoma. The iris (the pigment part of eyes: brown, blue, green...) of the narrow angle glaucoma patient is too close to drainage area of the eye, and so reduces the rate of fluid that can exit the eye. This situation may never cause a problem, but sometimes it does and and be quite severe.

There are two types of narrow angle glaucoma. The first, and most serious, is acute angle closure glaucoma. This is considered a medical emergency, and occurs when the iris suddenly plugs the drainage area of the eye and completely prevents the fluid inside the eye from exiting, causing a sudden increase in the eye pressure. The symptoms of acute angle-closure glaucoma include red eyes, a sudden decrease in vision, severe pain, headaches, nausea and vomiting. If not treated in time, it can lead to blindness, which may be irreversible.

The treatment for acute angle closure glaucoma primarily consists of creating an alternate pathway for the fluid to flow inside the eye. This can be done through surgery in the operating room or more commonly with a laser procedure in the office. There are eyedrops and oral medications that can lower the pressure in the eye, but they are not considered a definitive treatment and are often used only to reduce the pressure in the eye prior to treatment with the laser or surgery. Often, if one eye has suffered an acute angle closure glaucoma attack, the other eye will be treated with surgery or laser to prevent an attack in the future.

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