From the Guidelines
Closed angle glaucoma symptoms include sudden severe eye pain, headache, blurry vision, seeing halos around lights, nausea, vomiting, and redness of the eye, and patients should be asked about previous symptoms of intermittent angle closure, such as blurred vision, halos around lights, eye pain, headache, and eye redness, as identified in the 2021 study 1. These symptoms occur when the drainage angle in the eye suddenly becomes blocked, causing rapid increase in intraocular pressure. Other symptoms may include mid-dilated pupil that doesn't respond well to light, and tenderness around the eye. Some patients may experience these symptoms intermittently before a full attack, known as subacute attacks.
- Risk factors include being farsighted, Asian ancestry, older age, and having a family history of the condition, as well as the use of systemic medications that may cause ciliary body edema and angle narrowing, such as sulfonamides, including topiramate, and drugs with adrenergic or anticholinergic effects, such as ipratropium bromide and salbutamol-containing inhalers, phenothiazines 1.
- If you experience these symptoms, seek emergency medical care immediately as delayed treatment can lead to permanent vision loss.
- Treatment typically involves medications like timolol eye drops, oral acetazolamide, or IV mannitol to rapidly lower eye pressure, followed by laser procedures to create a drainage pathway, and early recognition of symptoms is crucial for preserving vision. The most recent and highest quality study, published in 2021 1, provides the best evidence for the symptoms and risk factors of closed angle glaucoma, and should be prioritized in clinical decision-making.
From the Research
Closed Angle Glaucoma Symptoms
- The symptoms of acute closed-angle glaucoma include:
- Eye redness
- Worsening of vision and other visual disturbances
- Headache
- Nausea 2
- These symptoms can be diverse and not always clearly referable to the eyes, leading to patients often presenting to physicians who are not ophthalmologists 2
- Acute closed-angle glaucoma is an ophthalmological emergency that requires immediate attention to prevent permanent vision damage 2, 3
- The goal of treatment for acute closed-angle glaucoma is to reduce intraocular pressure quickly with medications or surgery, and then prevent the recurrence of the obstruction to aqueous flow by a definitive ophthalmologic procedure 4
Importance of Prompt Treatment
- Delay in presentation and unresponsiveness to medical treatment of the acute ocular hypertension attack carry a significant risk of chronic glaucoma 3
- Proper, specific treatment can help patients rapidly and lastingly, and even physicians who are not ophthalmologists can diagnose markedly elevated intraocular pressure by palpation of the globe 2
- Primary care physicians can help decrease POAG-related vision loss by identifying patients with risk factors and referring them for evaluation by an eye specialist 4