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ACUTE ANGLE CLOSURE GLAUCOMA. With thanks to Frank and Alan Green. 2 Main Types of Glaucoma. Open Angle Closed Angle. Closed Angle Glaucoma. The Drainage Angle becomes blocked by the Iris and the pressure rises. Closed Angle Glaucoma. Rapid rise in pressure
ACUTE ANGLE CLOSURE GLAUCOMAWith thanks to Frank and Alan Green2 Main Types of Glaucoma Open Angle Closed AngleClosed Angle Glaucoma The Drainage Angle becomes blocked by the Iris and the pressure risesClosed Angle Glaucoma Rapid rise in pressure Headache and eye pain Rapid loss of vision May occur more slowly especially in AsiansAqueous Humour Made continuously by Ciliary Body Nourishes Cornea and Lens Drains through the Trabecular Meshwork in the Angle of the eyeCirculation of AqueousClosed Angle Glaucoma With age the Lens becomes bigger The Front Chamber becomes shallowerPupil Block There is increased contact between the Iris and the Lens Aqueous has difficulty getting through the Pupil Closed Angle Glaucoma The Aqueous is trapped behind the Iris and pushes it into the Drainage AngleIRIS CLOSES THE ANGLETreatment Immediate treatment is to lower the very high pressure by drugs Then make a hole in the Iris with a laser or by operation PERIPHERAL IRIDOTOMYPeripheral IridotomyA Peripheral Iridotomy creates a By- pass channel for the AqueousPeripheral IridotomyClosed Angle Glaucoma If the attack has been very severe and long lasting the drainage angle will have been permanently damaged and a Peripheral Iridotomy may not work completely The pressure may remain too high These patients will need a TrabeculectomyWhen to do Peripheral Iridotomy In the other eye of a patient with definite Closed Angle Glaucoma When the ophthalmologist thinks there isa risk of closed angle glaucoma by finding an eye with a shallow front chamberPrevention of Closed Angle Glaucoma A Peripheral Iridotomy will protect against angle closure if done BEFORE getting an attack by providing a BY PASSClosed Angle Glaucoma in World context 28 million Chinese at risk 5 million blind in 1 eye 2 million blind in both eyesShould all those at risk be found and have Iridotomies?
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