Is this happening to your eyes too? Let's learn about Angle-Closure Glaucoma!

Have you ever wondered what kind of problems can arise if the pressure in your eyes increases? You may have experienced things like sudden eye pain and blurred vision. Today we are going to talk about an eye disease that requires a little bit of attention, but can be controlled if you are properly informed. That is angle-closure glaucoma, or `(Angle-Closure Glaucoma)`.

What is Angle-Closure Glaucoma?

Simply put, angle-closure glaucoma is one of the two main types of glaucoma. Glaucoma is a condition in which the pressure inside your eye, medically known as Intraocular Pressure (IOP) , increases above normal levels.

Imagine, inside our eyes there is a special fluid called Aqueous Humor . This fluid is constantly being produced inside the eye, and the old fluid is being drained out of the eye. This happens through a system that is like a small drain. Now, what happens if for some reason the way this fluid is supposed to go out is blocked? That's when the pressure inside the eye increases.

In angle-closure glaucoma, the colored part of your eye, the iris, swells or bulges forward, blocking the drainage angle. This can happen suddenly or over time. Some people also call this closed-angle glaucoma.

Are there different types of angle-closure glaucoma?

Yes, there are several main types of this too. Let's see what they are.

1. Primary Angle-Closure Glaucoma

There are three ways to do this:

• Acute Angle-Closure Glaucoma: This is a very serious medical emergency. Because it occurs suddenly, if not treated properly , it can quickly lead to permanent vision loss. Symptoms include severe eye pain, blurred vision, seeing colored rings (halos) when looking at light, nausea, vomiting, and redness of the eye. This is a very serious condition. Imagine, Nilanthi Akka came home from work one day and suddenly felt a sharp pain in one of her eyes, seeing colored rings when looking at the light , and feeling like her head was going to explode. It was only because she went to the hospital quickly that her vision was saved.
• Intermittent Angle-Closure Glaucoma: This is when the fluid passageway opens and closes at times. Some people may have symptoms that come and go.
• Chronic Angle-Closure Glaucoma:This may not cause any symptoms at first. However, symptoms may appear gradually over time. Later, this may become severe, or the pressure in the eye may gradually increase and damage your optic nerve .

2. Secondary Angle-Closure Glaucoma

This type occurs with another medical condition. For example:

• Poorly controlled diabetes mellitus: This can lead to conditions like Proliferative Diabetes-Related Retinopathy.
• Conditions such as ``Ischemic Central Vein Occlusion'' due to poorly controlled high blood pressure or other blood vessel diseases.
• Uveitis (inflammation of the inside of the eye).
• Membranes and scars caused by eye injuries or inflammatory conditions.

How common is this disease?

According to statistics, about one in every 1,000 people will develop angle-closure glaucoma. This risk is especially high after the age of 40 .

According to one estimate, more than 17 million people over the age of 40 worldwide have primary angle-closure glaucoma. The largest number of these people, about 12 million, live in Asian countries. So, it is important to be aware of this in countries like ours.

What are the symptoms of angle-closure glaucoma?

As we've discussed before, acute angle-closure glaucoma can cause symptoms like:

• Severe eye pain (sometimes unbearable).
• Redness of the eyes.
• Loss or blurring of vision.
• Seeing rainbow-colored rings around light (Halos).
• Headache (sometimes on the same side of the eye).
• Nausea and vomiting.

If symptoms like these suddenly appear, it is very important to treat it as an emergency and seek medical advice as soon as possible!

Chronic and non-acute angle-closure glaucoma may not always cause symptoms, but sometimes you may see things like:

• Redness of the eyes.
• Blurred vision.
• Eye discomfort (like pain, heaviness).
• Headache or pain in the eyebrow area.

Why does angle-closure glaucoma occur?

This happens because, as we mentioned earlier, the fluid inside the eye called ``Aqueous Humor`` cannot enter or leave properly. Our body constantly produces new fluid to replace the old fluid.

When old fluid can't drain out of the eye, it builds up inside the eye and increases pressure. This increased pressure is what causes damage to the optic nerve, the main nerve that connects our eyes to the brain.

There can be many reasons for glaucoma to develop. But in angle-closure glaucoma, the main reason is that over time, the natural lens inside our eye thickens a bit, pushing it forward and blocking the path of the fluid that flows through the iris.

Is this something hereditary?

Research has shown that angle-closure glaucoma is linked to family history and that certain genes also play a role in it . This means that if someone in your family has the condition, you are at a higher risk of developing it too. Therefore, it is important to tell your doctor about your family history.

What are the risk factors for developing angle-closure glaucoma?

There are several main risk factors that contribute to this condition:

• Age: The risk increases as you age, as intraocular pressure (IOP) can increase and changes in the eye can occur.
• Gender: Women are at higher risk of developing this condition.
• Race: People of Asian descent (like us) are at higher risk.

What are the possible complications of this?

Like other types of glaucoma, angle-closure glaucoma can damage your optic nerve and lead to permanent vision loss. That's why it's so important to diagnose and treat it early.

How is this disease diagnosed?

When you go to see a doctor, he or she will first ask you about your symptoms, your medical history, and whether anyone in your family has had similar illnesses.

Then your eye doctor will perform a thorough eye exam .

What are the diagnostic tests?

The doctor uses tests like these to diagnose angle-closure glaucoma:

• Gonioscopy: This can check the drainage angle of your eye.
• Slit-lamp Exam: This is a special microscope that allows the doctor to see the inside of your eye.
• Tests that measure intraocular pressure (IOP).
• Visual Field Tests: This tests your peripheral vision.
• Imaging tests: For example, tests like Optical Coherence Tomography (OCT) or Ultrasound.

If your doctor thinks you have angle-closure glaucoma, he or she will avoid using medications that enlarge the pupil of your eye, as these medications can make the drainage of fluid worse.

How is angle-closure glaucoma treated?

To be honest, angle-closure glaucomaIt cannot be cured completely, but there are treatments to control it and minimize the damage to vision.

Treatment of acute angle-closure glaucoma

This condition needs to be treated quickly to prevent vision loss. Your doctor may suggest treatments such as:

• Medications: This may include eye drops (such as Timolol, Pilocarpine, and Brimonidine) and oral tablets such as Acetazolamide.
• Laser Iridotomy: This is a procedure that uses a laser beam. Here, a small hole is made in your iris to allow the fluid to flow freely. If you have acute angle-closure glaucoma in one eye, your doctor will often do this laser iridotomy in both eyes. Otherwise, there is a risk that your other eye will also develop the condition.

Treatment of non-acute angle-closure glaucoma

The doctor often suggests laser iridotomy for mild cases of angle-closure glaucoma.

The doctor may also suggest cataract removal surgery , as it can slow the progression of chronic angle-closure glaucoma.

Complications or side effects of treatment

After laser treatment, you may experience blurred vision and light sensitivity for a few days. You may also see a streak of light from the laser treatment site. You will usually be asked to drive with someone after this treatment. However, you can resume your normal activities the next day.

What can I expect if I have angle-closure glaucoma?

If you treat angle-closure glaucoma properly, your condition should improve. If it is acute angle-closure glaucoma, prompt treatment is essential to save your vision.

It's important to get your eyes checked regularly, as your doctor recommends.

Can angle-closure glaucoma be prevented?

No, angle-closure glaucoma cannot be completely prevented. However, regular eye exams by an ophthalmologist can help you determine if you are at risk. If you are at risk, your doctor can advise you on which medications to avoid and what treatments to take. Also, if you have diabetes, it is important to control your blood sugar levels.

When should I see my doctor?

If you notice any changes in your vision, be sure to see an ophthalmologist. Also, go for tests according to the schedule he or she prescribes for you.

When should I go to the emergency room?

You should seek emergency medical attention in these situations. This may include calling your eye doctor or going to an emergency room:

• If symptoms start suddenly (e.g., loss of vision).
• If you experience severe eye pain.
• If several symptoms occur together (e.g., eye redness, nausea, and eye pain).
• If there is an eye injury.
• If symptoms appear after any type of eye surgery.

What questions should I ask my doctor or ophthalmologist?

You can ask your medical team questions like these:

• What type of glaucoma do I have?
• What treatment do you recommend?
• Is the type of glaucoma I have hereditary?
• What are the side effects of the treatment?
• What will my situation be like in the short and long term?
• Are there any activities I should avoid?
• How often should I make appointments?
• Am I eligible to participate in a clinical trial?
• Do you know of any support groups I can join?

It's helpful to write down important points during your appointment. It's also a good idea to bring a family member or friend with you to help you ask questions and remember the answers.

Finally, things to remember (Take-Home Message)

Glaucoma is a common disease, and there are many types of it. Angle-closure glaucoma is one of those types. If you develop acute angle-closure glaucoma, it should be treated as a medical emergency.

If you experience symptoms such as eye pain, headache, redness, and nausea, call your doctor or go to the emergency room right away. You may need urgent medical attention to save your vision. Other types of angle-closure glaucoma also require treatment. As with any condition, early detection and treatment are the best ways to treat it. Don't panic, awareness is the greatest strength!

Angle -Closure Glaucoma, Glaucoma, Eye Pressure, Optic Nerve, Vision Loss, Eye Pain, Laser Treatment