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Jul 9, 2024 · Narrow angles refer to a condition where the drainage angle in the eye is blocked, leading to increased eye pressure and potential vision loss. Causes of narrow angles include anatomical factors such as a shallow anterior chamber, as well as age-related changes in the eye.
Treatments for anatomically narrow angles are straightforward, and new evidence suggests that lens extraction may be more effective in some patients than LPI. Although LPI is a relatively straightforward procedure, it is not without risk. Glare, blurred vision, iritis, and hyphema are all associated with LPI.
- Overview
- What is narrow angle glaucoma?
- How common is narrow angle glaucoma?
- Is narrow angle glaucoma serious?
- Signs and symptoms
- Stages of narrow angle glaucoma
- Causes of narrow angle glaucoma
- Treatment for narrow angle glaucoma
- Is narrow angle glaucoma curable?
- Things to avoid
Glaucoma is when the optic nerve in the eye becomes damaged. The different stages of narrow angle glaucoma relate to the extent of the damage to the optic nerve and the level of pressure in the eye.
Narrow angle glaucoma occurs because the angle between the iris and cornea is too narrow, preventing fluid from draining from the eye.
When fluid cannot drain from the eye as it should, pressure increases inside the eyeball, which can potentially lead to permanent damage if a person does not get treatment.
Narrow angle glaucoma can be acute or chronic. The acute form requires immediate medical attention. For both types, early diagnosis and treatment can help prevent vision loss.
Narrow angle glaucoma is a condition that causes an increase in pressure inside the eye, potentially damaging the optic nerve. This occurs due to changes in the iris, or the colored part of the eye, and the cornea, which is the transparent tissue that sits over the top of it.
The eye constantly produces fluid, which gives the eyeball its shape. Channels around the iris allow the fluid to drain away. If the iris presses forwards, the angle between the iris and cornea narrows.
There are two forms of narrow angle glaucoma: acute and chronic. In the chronic form, the angle remains narrow but not completely blocked. Some fluid can still drain, but not as much.
In the acute form, the iris obstructs the drainage channels, causing a sudden increase in pressure inside the eye. A truly acute narrow-angle closure will not resolve on its own.
The rates of narrow angle glaucoma vary between ethnicities. Among white people, it is rare, with an estimated prevalence of 3.8% among white people in the United States. It is much more common in people with East Asian heritage, particularly people from Thailand, Myanmar, and China.
Around 9 in 10 glaucoma cases in white people are open angle. In Asian populations, around 9 in 10 of all glaucoma cases are narrow angle.
Narrow angle glaucoma can have a serious impact on vision. Despite being less common than open angle glaucoma, narrow angle is the cause of 50% of all blindness cases that occur due to glaucoma.
If a person does not get treatment, both acute and chronic narrow angle glaucoma can lead to permanent vision loss. The acute form develops quickly, so it can cause vision changes within hours.
The symptoms of narrow angle glaucoma vary depending on whether it is chronic or acute. The acute form causes a sudden onset of symptoms, including:
•severe one-sided eye pain
•headache
•nausea and vomiting
•blurred vision
•rainbow-colored halos around lights
Doctors describe how severe a person’s angle closure is by using a staging system. These stages include:
1.Primary angle closure suspect (PACS): This is when the iris is touching the spongy tissue near the cornea, which is known as the trabecular meshwork. Eye pressure is typical, and there are no adhesions between the iris and angle structures and no damage to the optic nerve.
2.Primary angle closure (PAC): This means that pressure is elevated, but there is no damage to the optic nerve.
3.Primary angle closure glaucoma (PACG): This describes optic nerve damage and raised eye pressure. However, in chronic forms, the pressure can be normal.
Narrow angle glaucoma occurs when fluid cannot drain from the eye as it should. Several factors can raise the risk of this happening, such as:
•Family history: People inherit the features of their eyes from their parents and, therefore, risk of narrow angle glaucoma.
•Older age: Narrow angles are not present in younger people, but because the lens in the eye continues to grow with age, it can push the iris forward over time. This narrows the angle between the iris and cornea.
•Sex: Females develop narrow angle glaucoma more often than males, with an incidence ratio of 4:1. It is unclear why this is the case.
Treatment for narrow angle glaucoma involves reducing pressure in the eye and taking steps to improve fluid drainage.
In acute cases, this involves emergency treatment to stabilize eye pressure via medications, which may include:
•beta-blockers
•alpha-agonists
•carbonic anhydrase inhibitors
•prostaglandin analogs
Yes, narrow angle glaucoma is curable. The outcome depends on how quickly doctors detect and treat it. Seeking treatment early is crucial for the long-term outcome of the condition.
In people who have not undergone surgery for narrow angle glaucoma, there is a risk that certain activities or medications will cause an acute attack.
For this reason, people with a history of narrow glaucoma should try to avoid dim light, as this can cause the irises to dilate wide open. Eye drops that dilate the eyes can also pose a risk, along with many other medications, including:
•antihistamines such as diphenhydramine (Benadryl), loratadine (Claritin), and cetirizine (Zyrtec)
•certain antidepressants, such as fluoxetine (Prozac), paroxetine (Paxil), amitriptyline (Elavil), and duloxetine (Cymbalta)
•the headache medication sumatriptan (Imitrex)
•sulfa drugs such as topiramate (Topamax), acetazolamide (Diamox), and trimethoprim-sulfamethoxazole (Bactrim)
Jul 23, 2020 · Generally, narrow-angle glaucoma is caused by the iris (the colored part of the eye that surrounds the pupil) being bowed forward, restricting the space between the clear cornea and the iris where the drainage angle of the eye is located.
What does narrow angle mean? The “drainage angle” is the part of the eye that drains fluid from the front chamber of the eye. This drainage angle sits between the front of the iris (the coloured part of the eye) and the cornea (the clear window at the front of the eye).
Glaucoma is a common eye condition where the optic nerve, which connects the eye to the brain, becomes damaged. It's usually caused by fluid building up in the front part of the eye, which increases pressure inside the eye. Glaucoma can lead to loss of vision if it's not diagnosed and treated early.
Jan 10, 2024 · When it comes to treating narrow angles, the recommendations have changed over the last few years. Today, observation is a reasonable option to consider for primary angle-closure suspects (PAC-S) in addition to prophylactic laser peripheral iridotomies, and clear lens extraction is more widely accepted for treating primary angle-closure (PAC ...
