ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Angle-Closure Glaucoma

Updated on July 7, 2011


Glaucoma is a group of eye diseases that cause vision loss and blindness through damage to the optic nerve. Several factors contribute to its development, but the main culprit is elevated intraocular pressure (IOP), that is, pressure within the eye. Theoretically, glaucoma can be managed and vision loss prevented or minimized with early detection and medical treatment to control intraocular pressure. But the most common form, called open-angle glaucoma, progresses so slowly and subtly that symptoms, such as blind spots and reduced peripheral vision, may go unnoticed until the disease has advanced and vision loss is inevitable.

This discussion will focus on one specific type of glaucoma, referred to as narrow angle-closure glaucoma, caused by the closing down of the angles of the canals where fluid circulates, between the iris and the corea in the eyes. This, in turn, precipitates IOP and leads to damage and possible blindness. Certain individuals have eyes with narrow angles. It is a hereditary condition and affects around 10-15 percent of the population. If a person has narrow angles, it means that the angle between the outer edge of the iris and the cornea is narrower, or more closed, than normal. This can affect fluid flow and, in turn, the IOP in the eyes (see illustration).

Angle-closure glaucoma

People who are farsighted are at greater risk for this condition because they tend to have a shallow anterior canal (the fluid-filled space at the front of the eye) in their eyes, which narrows the angle between the iris and cornea. In addition, as a person grows older, their eye lenses become thicker from front to back. As the lens pushes forward, the angle between the iris and cornea narrows, and resistance to fluid flow between the iris and lens increases. If fluid accumulates behind the iris, the iris may bulge forward and block the eye’s drainage system or "trabecular meshwork", located at the junction of the outer iris and the cornea.This, in turn causes IOP to build up.

In normal eyes, the fluid flows through the pupil to the front of the eye through the trabecular meshwork, But in eyes with narrow angles, the drainage angle where the iris meets the cornea is narrower than normal. This slows or blocks the flow of fluid (aqueous humor) out of the eye. Pressure from the aqueous humor behind the iris forces it against the trabecular meshwork. The fluid then accumulates behind the iris, which in turn pushed the iris forward, closing the drainage angles completely. If this happens, it is referred to as acute closed-angle glaucoma and can result in extreme pain, damage to the optic nerve and/or blindness.

There are rarely any symptoms in the early stages of the disease so regular eye check-ups by qualified professionals are important. Ophthalmologists and optometrists will diagnose glaucoma on the basis of intraocular pressure, visual field results and optic nerve head appearance.

Patients will sometimes notice patchy loss of peripheral vision or reduced contrast sensitivity and these people may benefit from a review by an eye specialist. Symptoms of angle-closure glaucoma can include pain in or behind the eyeball, headache with nausea and vomiting and visual disturbances with halos around lights, but sometimes there are no symptoms

Preventative Measures

There are measures a person with narrow angles can take to make sure their condition does not develop into angle-closure glaucoma. First of all they should see a good Opthamologist on a regular basis, preferably one who specializes in glaucoma. He wont dilate your eyes. Persons with this condition cannot have their eyes dilated, in the doctor's office, or use any medicines or eye drops which would dilate the eyes, for fear of increasing the pressure and having the angles close down completely.

With a series of examinations, the doctor will be a able to determine whether or not pressure is building up in your eyes and just how narrow your angles are. He'll probably want to see you frequently, to determine if and when the pressure fluctuates, or if the angles appear to be getting any narrower. From tracking your condition, he'll be able to tell you at which point surgery is recommended, if at all.

If surgery is reccommended

Narrow angles may be a precursor to angle closure glaucoma, which has a sudden, painful onset or a slow unrelenting downhill course. The best time to prevent the damage that angle closure glaucoma can cause is to treat it with a laser iridotomy before the actual disease sets in. This is preventative medicine at its best.

Although not everyone with narrow angles actually develops glaucoma, careful evaluation of the angle structure can identify who is at greatest risk. The angle structure is determined by an examination called gonioscopy which is performed with a special contact lens called a gonioprism

All glaucoma surgery procedures (whether laser or non-laser) are designed to accomplish one of two basic results: decrease the production of intraocular fluid (aqueous humor) or increase the outflow (drainage) of this same fluid. Occasionally, a procedure will accomplish both. Currently the goal of glaucoma surgery and other glaucoma treatment is to reduce or stabilize  IOP. When this goal is accomplished, damage to ocular structures — especially the optic nerve may be prevented.

No matter the treatment, early diagnosis is the best way to prevent vision loss from glaucoma. See your eye care practitioner routinely for a complete eye examination, including a check of your IOP. People at high risk for glaucoma due to elevated intraocular pressure, family history, ethnic background, age or optic nerve appearance may need more frequent visits to the eye doctor.

*Lazer surgery for closed-angle glaucoma


The goal of treatment is to reduce intraocular pressure (IOP) as soon as possible. This can be done with systemic medications taken orally or sometimes given intravenously. Topical glaucoma eye drops are also often used to treat narrow-angle glaucoma. But more frequently, laser and/or non laser glaucoma surgery may be required to reduce the IOP.

Remember that acute angle-closure glaucoma may be triggered by anything dilating the pupil, resulting in the iris blocking the angles. Dim lighting, eye drops administered by your eye care practitioner during an eye examination, or certain medications such as antihistamine/decongestant drops or cold medications may cause an acute angle-closure glaucoma attack.

In acute forms of glaucoma, optic nerve damage and vision loss will occur within hours if the angles of the interior eye structure are not opened to drain fluid and lower IOP.


An iridotomy is a type of lazer surgey that can be done in the doctor's office. It is painless and only takes a short amount of time. In an iridotomy (*see diagram above), a laser is used to create a hole in the iris to enhance the drainage passages blocked by a portion of the iris. In most cases, the procedure is done on only one eye at a time, with a short waiting period in between. After the procedure, the patient rests the eye, at home for a day or two, using prescribed eyedrops to reduce possible inflamation, infection, and to soothe the eye.

*Note I had two iridotomies last year. I put the surgery off for way too long, because of fear of having surgery on my eyes, lazer or otherwise. I finally succumbed, after repeated urging from my doctors and family. The experience was amazing. It only took a short time and was completely painless. Of course, I've had narrow angles my whole life, having been born with them, and should have done this much sooner. I just found out my daughter has the same condition.

Part 2: surgery for narrow angles


    0 of 8192 characters used
    Post Comment
    • alekhouse profile imageAUTHOR

      Nancy Hinchliff 

      4 years ago from Essex Junction, Vermont

      Glad you had it taken care of. Thanks for the comment.

    • profile image


      4 years ago

      I have just had the laser surgery on three days ago here in NZ. I am 45 years old. This was not painful, I go for a check-up in a few weeks to check if the holes made are large enough if so all done for rest of life. Of course my diet had nothing to do with the condition I was born with. I just took 45 years to get an eye test which is how it was first diagnosed.

    • alekhouse profile imageAUTHOR

      Nancy Hinchliff 

      9 years ago from Essex Junction, Vermont

      You are very welcome. Glad you enjoyed it.

    • Journey * profile image

      Nyesha Pagnou MPH 

      9 years ago from USA

      This is thorough and worthwhile information. Thanks for sharing.

    • alekhouse profile imageAUTHOR

      Nancy Hinchliff 

      9 years ago from Essex Junction, Vermont

      Thanks, Dolores. Yes, now that I've had the iridotomies and my eyes have been fine so far. I can "see" that I did the right thing. I get check-ups on a regular basis, in fact I have an appointment tomorrow. Wish me luck.

    • Dolores Monet profile image

      Dolores Monet 

      9 years ago from East Coast, United States

      A great reason to visit the eye doctor regularly. You certainly provided us with a lot of information here. Voted up!

    • alekhouse profile imageAUTHOR

      Nancy Hinchliff 

      10 years ago from Essex Junction, Vermont

      I was born with narrow angles. This condition is congenital. So vitamins and minerals will not help. However; diet certainly is an important factor in maintaining a healthy body. Thanks for the info.

    • mrbill15 profile image


      10 years ago from Cave Creek

      Focus On What’s Important

      What we feed our bodies feeds our eyes. Many of the vitamins and minerals in our bodies are found in much higher concentrations in our eyes, so a diet lacking in these vitamins and minerals can lead to vision problems as we grow older.

    • alekhouse profile imageAUTHOR

      Nancy Hinchliff 

      11 years ago from Essex Junction, Vermont

      Glad you enjoyed the hub. Thanks for stopping by. The procedure went very well for me, nice of you to ask.

    • RedElf profile image


      11 years ago from Canada

      Fascinating. I had my eyes tested just recently, but I had no idea this was one of the things they look for. Very informative. Glad it went well for you.

    • alekhouse profile imageAUTHOR

      Nancy Hinchliff 

      11 years ago from Essex Junction, Vermont

      Probably a good idea for everyone. Have you ever had one? Thanks for the comment

    • Gypsy Willow profile image

      Gypsy Willow 

      11 years ago from Lake Tahoe Nevada USA , Wales UK and Taupo New Zealand

      Very interesting. You have goaded me to have an eye check, thanks


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)
    ClickscoThis is a data management platform studying reader behavior (Privacy Policy)