Narrow (or acute) angle glaucoma is a pathological condition of the eye which occurs when the iris pushes forward and blocks the internal drainage system known as the trabecular meshwork, causing a buildup of fluid within the eye. Once the fluid builds up, it can cause the intraocular pressure to rise quickly which can result in irreversible damage to the optic nerve. This can lead to vision loss or potentially blindness.
For Acute Angle-Closure Glaucoma, the effects are sudden and can appear in one or both eyes.
These signs may last for hours or until the intraocular pressure is reduced. With each narrow-angle glaucoma attack, part of your peripheral or central vision may be lost.
Acute angle-closure glaucoma is a medical emergency. If the high pressure is not reduced within hours, it can damage vision permanently. Anyone who experiences these symptoms should contact their ophthalmologist immediately or go to a hospital emergency room. Some chronic forms of narrow-angle glaucoma can progress very slowly and cause eye damage without any obvious symptoms or pain in the early stages.
A diagnosis of narrow-angle glaucoma does not necessarily result in severe vision loss, as it can be prevented if the anatomical variation is observed by slit lamp examination and confirmed with gonioscopy. Additional tools helpful in evaluating this specific variant of glaucoma are the ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT). Both allow for detailed visualization of internal ocular structures related to the drainage angle and surrounding anatomy. These tools can aid in diagnosis and monitor post-treatment outcome.
Traditional intraocular lowering medications can be used, however, long-term treatment lies in correcting for this anatomical anomaly by releasing the build of aqueous fluid through an alternate means.
In order to treat both acute narrow-angle glaucoma and chronic narrow-angle glaucoma, we offer the narrow-angle glaucoma laser treatment known as laser iridotomy.
Simply stated, the narrow angle glaucoma laser treatment known as laser iridotomy opens a narrow drainage angle in the eye. Since the angle is the part of the eye that drains fluid, narrowing of the angle can put the eye at risk for an acute attack of angle closure glaucoma. However, laser peripheral iridotomy (LPI) can prevent both acute attacks and the development of chronic narrow angle glaucoma.
During the LPI, a laser is used to make a small opening in the peripheral iris (the colored part of the eye). This changes the fluid dynamics in the eye and “opens” the angle. If you already have acute angle closure glaucoma, the small opening that is made in the peripheral iris allows fluid to drain more normally and also lowers the eye pressure.
A laser iridotomy is an outpatient procedure that can be performed at one of our offices. You are seated at a slit lamp with your forehead resting against a headpiece and your chin resting in a chin-rest. After some eye drops are used to numb the eye, a lens will be placed on your eye. This will prevent you from blinking and will also minimize your eye movements. The lens also helps direct the laser light into your eye. The laser, which is attached to the slit lamp equipment, is then directed into the eye.
The procedure usually takes a few minutes. Most people experience minimal discomfort during the procedure. After the laser, you may experience some irritation in the eye and some blurry vision, but this commonly resolves by the same evening of the procedure. You will have your eye pressure checked thirty minutes after the laser procedure with a follow up appointment one week after your laser iridotomy. The number and frequency of visits after the laser surgery may vary and depend on the condition of your eye. Most people will need to perform an eye drop regimen four times per day for one week to help the eye heal rapidly.
Let one of our board-certified surgeons help you find the right procedure to meet your glaucoma needs. Make an appointment at one of our eight convenient locations.
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