Narrow angle glaucoma is also called acute angle-closure glaucoma or closed-angle glaucoma.
The more common open-angle glaucoma is often referred to as the “sneak thief of sight” because most people with the disease do not experience symptoms. This monicker is not used for narrow angle glaucoma because it produces severe symptoms that cannot be overlooked.
Narrow Angle Glaucoma Symptoms
Because the eye pressure rises very high in a short period of time, most people will experience the following symptoms:
Blurred visionRed eyesHeadacheEye painHalos around lightsMid-dilated pupilNausea
If you are experiencing any of these symptoms, see your optometrist or ophthalmologist immediately, or go to your local emergency room.
It is important to note that some people with narrow angle glaucoma may not experience symptoms or may experience them intermittently, depending on what is causing the disease.
Causes
The front part of the eye houses the anterior chamber. Some people have a shallow anterior chamber, narrowing the angle of the eye. In such eyes, the iris can bunch up as the pupil dilates and close off the angle. The iris can sometimes close the angle by dilating in a dark room, such as a movie theater.
In some inflammatory eye diseases, the anterior chamber becomes very sticky, causing the back of the iris to stick to the lens of the eye. This causes fluid to back up and push the iris forward, closing off the angle, called pupillary block. Tumors and severe diabetic eye disease can also cause narrow angle glaucoma.
Risk Factors
The following risk factors are associated with narrow angle glaucoma:
Farsightedness: Farsighted individuals are more likely to have a shallow anterior chamber. Age: Aging causes changes in the anatomy of the eye, putting you at risk for developing the disease. Race: Asians and Inuit people have a higher risk of developing narrow angle glaucoma because they have a shallow anterior chamber and anatomically narrow angles. Sex: Women are more likely to have narrow angle glaucoma. Cataracts: Cataracts can grow and make the lens of the eye thicker, often pushing the iris forward and causing pupillary block.
Treatment
Narrow angle glaucoma treatment must begin immediately. Once officially diagnosed, topical glaucoma eye drops are instilled in an attempt to lower the pressure as quickly as possible.
Many times, an oral medication called acetazolamide is given to reduce the pressure and fluid systemically. Sometimes doctors will have you drink a solution like isosorbide or mannitol to aid in reducing the pressure and fluid.
Next, glaucoma doctors will perform a laser procedure called a peripheral iridotomy (PI) to allow the fluid to escape through the iris. An iridotomy is a very small hole in the iris that allows the fluid to pass through.
Prevention
It is possible to identify people who may be at risk for developing narrow angle glaucoma. Physicians can perform a peripheral iridotomy (PI) as described above even if you are not experiencing symptoms.
In this manner, if the angle does close, the iridotomy will allow the fluid a chance to escape so pressure does not rise to dangerous levels. People who have an iridotomy should be examined on an annual basis to ensure that the iridotomy is still open and has not grown closed.
