Narrow Angle Glaucoma

Narrow Angles and Narrow Angle Glaucoma are uncommon abnormalities, that are usually found in patient’s eyes when they come for their routine exam. Patients do not generally have any complaints or problems related to this issue. The exception to this statement is when patients experience an even more uncommon problem, known as Angle Closure Glaucoma. This crisis situation presents itself very differently, and will be discussed below. Not everyone with narrow angles develops narrow angle glaucoma, and this type of glaucoma is preventable.

What is Narrow Angle Glaucoma?

Narrow angles are a problem with the drainage system inside the eye. This area allows proper circulation of fluid inside the eye, to maintain pressure. If the angle is too narrow, there is a risk for closure of this drainage system with sudden and dangerous elevation of the pressure in the eye. In general, Narrow Angles are an abnormality that patients have from birth, and it progresses with age.

What are the symptoms of Narrow Angles?

Unfortunately, Narrow Angles can only be detected with an eye examination. It is recommended that all patients have regular eye exams.

What are the common symptoms of Angle Closure?

The symptoms of Acute Angle Closure are severe and rapid in onset. The usual symptoms are:

• Blurred vision
  As the angle closes and the pressure rises, swelling begins in the cornea (the front ‘window’) of the eye. The vision begins to blur, and glare and halos around light are common.
• Redness and Pain
  As the pressure continues to increase, the eye becomes inflamed and painful. At this point, patients are usually either on the phone with their eye doctor, or on the way to the emergency room.
• Nausea and Vomiting
  The pain can become so intense that patients become physically ill. There are actually reports of patients ending up with abdominal surgery due to the severity of this symptom.

What is the treatment for narrow angles?

The key to treatment of Narrow Angles (and prevention of angle closure) is directed at detection and prevention. During the initial exam, a “shallow angle” may be detected. A special examination technique, known as gonioscopy, allows the doctor to see the drainage area of the eye. The angle can be observed and graded. When a patient has angles that are less than or equal to “grade 2”, they are considered at risk for angle closure. To prevent angle closure glaucoma, a vision-threatening problem, laser energy may be used to place a small hole in the iris (the colored portion of the eye).