Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor drainage. However, pilocarpine can cause side effects such as blurred vision and night blindness. Long-term treatment options include laser iridotomy, which creates a hole in the iris for aqueous humor drainage, and trabeculectomy. This surgical procedure removes a section of the iris and creates a new path for drainage. Trabeculectomy is also referred to as filtration surgery since the drained aqueous humor collects in the filtering bleb.
In angle‐closure glaucoma, the bulged iris results in a closed iridocorneal angle, effectively occluding the Schlemm's canal.
The obstruction halts aqueous humor outflow, leading to a sudden increase in the intraocular pressure. This triggers acute symptoms such as nausea, eye congestion, vomiting and severe headache.
Treatment of angle-closure glaucoma involves both short-term medical management and long-term surgical route.
Short-term emergency treatment is aims to lower the acute intraocular pressure prior to surgery.
For example, pilocarpine, a cholinomimetic drug, effectively increases the aqueous humor drainage by opening the trabecular meshwork.
However, its prolonged usage may result in side effects such as blurred vision and night blindness.
Long-term treatment for angle-closure glaucoma comprises laser and surgical procedures.
In laser iridotomy, a laser beam is used to create a hole in the iris. This restores the conventional path for aqueous humor outflow via the trabecular meshwork.
In trabeculectomy, an alternative path is created surgically to allow the outflow of aqueous humor, bypassing the blocked iridocorneal angle.