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Narrow-angle glaucoma: Symptoms and treatment Print E-mail

Tuesday, 24 July 2012 00:00

Written by Vonda Sines

It sometimes takes a long time for a patient to finally get a correct diagnosis of narrow-angle glaucoma.  Many sufferers are utterly convinced – and emergency-room personnel often agree – that they’re experiencing migraine attacks. 

Narrow-angle is one of several types of glaucoma.  It also goes by the names acute glaucoma and angle closure glaucoma.  This condition requires immediate medical treatment when an attack occurs in order to preserve the patient’s sight.

Any form of glaucoma is serious.  As a matter of fact, without the correct treatment, it can lead to irreversible blindness, according to WebMD.

The cause of glaucoma is an excessive buildup of pressure within the eye.  Individuals older than 40 have an elevated risk for it, particularly if there’s a family history of the disorder.  African-Americans and those descended from Irish, Russian, Japanese and Hispanic ancestors are at higher risk than the general population is.  So are those of Inuit or Scandinavian descent. 

Taking steroids like prednisone for a prolonged period and being a diabetic are additional risk factors.  As a matter of fact, MedlinePlus tags glaucoma as the second most common cause of blindness in the United States.


The most deceptive thing about glaucoma is that most patients are unaware of any symptoms.  However, the narrow-angle variety shows itself in attack mode.  The attack occurs because of a sudden buildup of eye pressure.

Patients with narrow-angle glaucoma experience this buildup because of insufficient drainage of the eye’s aqueous humor through a natural eye drainage channel.  Often the culprit is an odd angle between the cornea and the iris that prevents this clear fluid from properly draining.

The most typical symptoms of this condition are severe pain in the eye, frequently accompanied by cloudy or decreased vision.  Some individuals report seeing halos that look like rainbows around lights.  Others experience nausea, vomiting, a sensation that the eye is swollen and an eye that appears red.  Some patients experience attacks involving both eyes.  Because many of these symptoms are similar to those of a migraine, narrow-angle glaucoma patients often have a difficult time getting the right diagnosis.


The goal of treating a narrow-angle attack is reducing the pressure in the eye affected as quickly as possible.  Onset of any of the symptoms requires immediate medical treatment.  Unlike conventional glaucoma, which destroys sight over an extended period, the narrow-angle type can result in blindness within a few days without prompt treatment.  Patients who experience an attack involving one eye are also at risk for a similar event in the other one.

Merely taking the pressure of an affected eye isn’t a sufficient exam.  This is because the eye pressure of around a quarter of all glaucoma patients generates a normal reading

Several types of treatment can counteract an attack.  They include eye drops, pills and IV medications.  When these fail to quickly lower the pressure in the affected eye, doctors resort to an iridotomy, an emergency surgery that uses a laser to construct a new channel in the eye.  This procedure relieves the buildup of pressure and should prevent more attacks.

Some patients considered high-risk for narrow-angle glaucoma choose to undergo an iridotomy before they have any attacks.  In general, if a patient suffers an attack but gets immediate and appropriate medical treatment for it, he or she has a good chance of avoiding blindness.


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