Acute angle closure glaucoma
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Acute angle closure glaucoma is probably the best known type of glaucoma. Apposition of the lens to the back of the iris prevents the flow of aqueous from the posterior chamber to the anterior chamber. Acute angle closure glaucoma is treated with a different type of laser to create a tiny hole in the iris to relieve the pressure problem. Acute angle closure glaucoma is an emergency which must be treated by an ophthalmologist immediately or severe loss of vision can result.
Acute angle closure glaucoma is more common in Asian (oriental) people than in people of European descent; it is rare in people of African descent. Acute angle closure glaucoma is more common in females because females have eyes that are generally smaller than those of males. Similarly, angle closure glaucoma occurs more frequently with increased age, because as the lens of the eye grows larger with age, the anterior segment of the eye becomes more crowded and the drainage angle becomes narrower.
Close the bottle immediately after use. Keep the eyes closed for at least 20 seconds after instillation. Closed angle glaucoma is most common in those who are farsighted. Occasionally, closed angle glaucoma blockage is sudden, and the rapid rise in intraocular pressure can cause severe pain and vision loss.
Angle-closure glaucoma cannot be prevented, but prompt medical treatment can reduce the risk of vision loss. Patients at high risk of having an angle-closure glaucoma attack may undergo preventive surgery to open a new channel in the iris. Angle-closure glaucoma is characterized by narrowing of the angle formed by the lateral edge of the iris and the cornea, typically not found in "open-angle" glaucoma. Acute angle-closure glaucoma (AACG) is an ocular emergency that can be reversed if treated immediately and appropriately.
Treatment of acute angle-closure glaucoma is now better adapted for each stage of the disease. The urgent necessity to lower intraocular pressure is normally achieved using medical therapy followed by laser peripheral iridotomy and sometimes by filtration surgery.
Pressure build-up and subsequent damage to the optic nerve is almost always caused by some type of blockage of the various drainage mechanisms of the eye. The type of glaucoma that is diagnosed by the ophthalmologist can be defined by the type of blockage that has occurred. Pressure builds up in the eye when the clear liquid called the aqueous humor, which normally flows in and out of the eye, is prevented from draining properly. This can happen in different ways, depending on the type of glaucoma.
Vision is often affected and visual recovery is variable. Following an attack the cornea frequently develops folds in Descemet's membrane; recovery is usually complete, although some degree of endothelial cell loss may occur. Vision loss occurs over years and is usually unnoticed by patients until it is advanced.
Patients should discuss these issues with both the family physician and the eyecare practitioner. Patients with 'angle closure' glaucoma require laser treatment and may also require a cataract procedure. When eye-drops and other such medical treatments are not enough, surgery is required. Patients tend to complain of decreased distance and /or reading vision, decreased night vision, loss of image clarity, dulling of colors and increasing glare around lights.
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