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Glaucoma – Narrow Angle 2021-02-09T06:17:18-05:00

Narrow-angle glaucoma can lead to sudden blindness

This less common type of glaucoma can cause minor or severe symptoms which require urgent medical attention
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Narrow-angle glaucoma affects your freedom and daily tasks

DISCOVER MORE ABOUT THIS CONDITION AND HOW TO TREAT IT

Narrow-angle glaucoma, also called closed-angle glaucoma, is a less common form of glaucoma.

The likelihood of developing narrow-angle glaucoma increases if you:

  • Have far-sighted eyes (shorter eye anatomy)
  • If you’re frequently exposed to anything that causes the pupils to dilate e.g. dim lighting, dilation drops
  • Use certain oral or injected medications
  • Experience a blow to the eye
  • Have diabetes-related growth of abnormal blood vessels over the angle

Symptoms of acute narrow-angle glaucoma

The onset of acute narrow-angle glaucoma is typically rapid, constituting an emergency. If not treated promptly, this glaucoma produces blindness in the affected eye within hours to days. Symptoms may include:

  • Inflammation and pain
  • Pressure over the eye
  • Moderate pupil dilation that’s non-reactive to light
  • A cloudy cornea
  • Blurring and decreased visual acuity
  • Extreme sensitivity to light
  • Seeing halos around lights
  • Nausea and/or vomiting

This type of glaucoma results from a bulging iris that blocks or causes narrowing of the drainage canals in the eye.

This type of glaucoma has two forms: acute angle-closure glaucoma and chronic angle-closure glaucoma.

In the acute form, the drainage of fluid becomes blocked, causing a sudden and drastic elevation of pressure usually in one eye. Typically there is severe eye pain, nausea, vomiting, halos or loss of vision in the acute form and if not treated emergently, permanent loss of vision can occur quickly.

Chronic angle-closure glaucoma, on the other hand, is more similar to open-angle glaucoma. There is a slow progression of visual loss and typically, no visual symptoms.

Everyone should be checked for glaucoma at around age 35 and again at age 40. Those considered to be at higher risk for narrow-angle glaucoma, including those who are Asian, farsighted or over the age of 60, should have their pressure checked every year or two.

Because of the rapid, potentially devastating results of narrow-angle glaucoma, you should seek medical treatment immediately if you experience any of the above symptoms.

During eye exams, your doctor will use tonometry to check your eye pressure. After applying numbing drops, the doctor gently presses the tonometer against the eye, measuring and recording its resistance.

The doctor can use an ophthalmoscope to examine the shape and color of your optic nerve. The ophthalmoscope magnifies and lights up the inside of the eye. If the optic nerve appears to be cupped or is not a healthy pink color, we can run additional tests.

The doctor can perform a gonioscopy exam to determine whether the angle where the iris meets the cornea is open or closed. This is a key difference between open-angle glaucoma and narrow-angle glaucoma.

Laser iridotomy is a common method to prevent narrow-angle glaucoma or to treat an episode of narrow-angle glaucoma.

During this procedure, we use a laser to create a small hole in the iris, restoring the flow of fluid to the front of the eye. In most patients, we place the hole in the upper portion of the iris, under the upper eyelid, where it cannot be seen.

We may give you medications, including topical eye drops and oral medicines, to lower the intraocular pressure in your eye.

We perform filtration surgery when medicines and/or laser surgery are unsuccessful in controlling eye pressure. During this microscopic procedure, we create a new drainage channel to allow fluid to drain from the eye.

I have had a laser iridotomy to prevent angle-closure. Does this need to be repeated?

The opening created by the laser is permanent and typically never needs to be repeated.

How long does the laser take and does it hurt?

The laser application itself only takes a few minutes. We will need to give you drops ahead of the procedure to constrict the pupil. We will need to allow at least half an hour for the drops to work.

You may experience a pinching sensation during each laser pulse; however, this is typically well-tolerated.

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I had my surgery done for a cataract and to correct my astigmatism. I can see better out of the eye that Dr Chotiner performed surgery on without the need for a corrective lens than I can see out of the other eye with my glasses on. The surgery was delayed because of the whole Covid virus closings, but when it was performed it went incredibly well and I could not be happier with the results.

Robin

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I cannot thank Dr. Chotiner and his staff enough for what they have done for me. I had LASIK here 16 years ago and that was a life changing event for me. Prior to that, my vision was always poor and then (after surgery) it was great. Now I have cataracts and once again, getting the first eye done was a life changing experience.

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Academic resources on glaucoma

FOLLOW THE LINKS BELOW TO DISCOVER MORE ABOUT THIS TREATMENT FROM AUTHORITATIVE SOURCES

Glaucoma damage is permanent—it cannot be reversed. But medicine and surgery help to stop further damage. To treat glaucoma, your ophthalmologist may use one or more of the following treatments. Click here to read on.

Surgery isn’t usually the first step to treat glaucoma, but it may save your eyesight if other treatments don’t work. Click here to read on.

This article explores the potential risks of glaucoma surgery and explains why the benefits outweigh risks for most advanced cases. Click here to read on.

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Dr. Bennett Chotiner
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MEDICAL DIRECTOR, GENERAL OPHTHALMOLOGY, CATARACT & REFRACTIVE SURGERY, LASIK SURGERY

Dr. Bennett Chotiner is the founder and medical director of Memorial Eye Institute. A noted innovator, in 1977 he established his clinical practice, the Pennsylvania Eye Associates. In 1984, he established the Pennsylvania Eye Surgery Center, Pennsylvania’s first …

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Dr. Erik A Chotiner
M.D., F.A.C.S.

GENERAL OPHTHALMOLOGY, CATARACT & REFRACTIVE SURGERY, LASIK SURGERY

Erik Chotiner, M.D. diagnoses and treats a wide range of medical eye conditions. He is a Phi Beta Kappa graduate of Franklin and Marshall College. Dr. Chotiner attended Jefferson Medical College in Philadelphia where he received multiple awards including the Physiology Prize for …

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Dr. Michael J. Silvetti
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