What Is Closed-Angle Glaucoma?
Closed-angle glaucoma is a condition in which the pressure inside
of your eye becomes too high. There are a number of diseases that fall under
the heading “glaucoma.” Open-angle glaucoma is the most common form of the
condition and it accounts for around 90 percent of
all cases of glaucoma. Closed-angle glaucoma is much less common. If left
untreated, all types of glaucoma may cause damage to your optic nerve (and
ultimately blindness), which is the nerve that transmits visual information to
If you have closed-angle glaucoma, pressure builds because fluid
is not flowing out of your eye as it should. Fluid is produced in the rear
chamber of your eye, behind the iris. This fluid normally flows through your
pupil into the front chamber of the eyeball. The fluid then goes through a
series of channels called the trabecular meshwork and into the veins of the
sclera (the white of your eye).
In closed-angle glaucoma, the trabecular meshwork is obstructed
or damaged. The fluid can’t flow as easily through this drainage pathway, or is
completely blocked. This fluid backup increases pressure within your eyeball.
Types of Closed-Angle Glaucoma
Closed-angle glaucoma can be divided into two main types.
Primary Closed-Angle Glaucoma
In primary closed-angle glaucoma, the structure of the eye makes
it more likely that the iris will become pressed against the trabecular
meshwork. This could be because:
- the angle between the iris and cornea is very
- the eyeball is relatively short as measured from
front to back
- the lens inside the eye is thick
- the iris is thin
Secondary Closed-Angle Glaucoma
In secondary closed-angle glaucoma, an underlying condition
causes changes in your eye that force the iris against the trabecular meshwork.
These underlying conditions may include:
- eye injury
- advanced cataract (clouding of the eye’s lens)
Closed-angle glaucoma can also be described as acute or chronic. Acute
cases are more common and occur suddenly. Chronic closed-angle glaucoma
develops gradually, making the symptoms harder to spot.
Who Is at Risk for Closed-Angle Glaucoma?
Your risk for closed-angle glaucoma is greater if you:
- are older than 40 years of age, especially if
you are between 60 and 70 years old
- are farsighted
- are female
- have a brother, sister, or parent with the
- are of Southeast Asian or Alaska Native origin
What Are the Symptoms of Closed-Angle Glaucoma?
If you have the acute form of the condition, you will likely
experience a sudden onset of one or more of the following symptoms:
- severe eye pain that comes on suddenly
- blurred vision
- bright halos appearing around objects
- eye redness, tenderness, and hardness
- feeling nauseated and vomiting
The attack may occur when your pupils are moderately dilated — for
example, when you are in a darkened room, when you are under stress, or after
taking certain drugs.
If you do experience any of these symptoms, you should call 911
or visit an emergency room right away. Acute closed-angle glaucoma is an
Symptoms of chronic closed-angle glaucoma are subtler. You may
not notice any changes, or, if the condition progresses, you may realize that
your sight is deteriorating and that you are losing the edges of your field of
vision. Occasionally, some people experience eye pain and redness, but not as
severely as in acute closed-angle glaucoma.
Diagnosing Closed-Angle Glaucoma
Your doctor will ask you questions about your condition, examine
your eyes, and measure your eye pressure. No special tests are needed. If
treated urgently, your eye can recover. Acute cases of closed-angle glaucoma
are emergencies and you should go to the hospital as quickly as possible. You
could lose your sight if you delay treatment.
Treating Closed-Angle Glaucoma
Medication and surgery are used to treat closed-angle glaucoma.
You may need a number of different drugs including:
which reduces the fluid in your eye
- beta blockers, which lower the amount of fluid
your eye produces
- steroids, which reduce inflammation
- painkillers (as a comfort measure)
- drugs to treat nausea and vomiting
which opens the angle between your iris and cornea
Once the pressure in your eye has decreased, you will need further
treatment to prevent the pressure from rising again. There are two surgeries
used to address closed-angle glaucoma:
Iridotomy. This is a laser treatment that creates two tiny drainage holes
in your iris. It is used to treat both acute and chronic closed-angle glaucoma.
Iridectomy. In this less-common treatment, a surgeon makes a small
triangular opening in your iris.
Preventing Closed-Angle Glaucoma
If you have a family history of glaucoma, you should have your
eyes checked regularly. Your doctor may recommend peripheral iridotomies to help
prevent an attack if you are at an especially high risk for closed-angle