Angle-Closure Glaucoma

Angle-Closure glaucoma makes up about 10 percent of glaucoma patients in the U.S. In this type of glaucoma the drainage passage is narrowed and then can become blocked. If angle closure is diagnosed early enough, a simple laser treatment may be used to improve drainage.

While glaucoma cannot be cured, treatments are available that can control the pressure. Asheville Eye Associates offers advanced diagnostic technology including Optical Coherence Tomography (OCT) to detect glaucoma earlier than traditional methods. The technology is non-invasive and can quickly evaluate if there is even a small amount of damage to the optic nerve. This technology is used to monitor glaucoma patients to ensure that the disorder is being controlled.


The drainage canals get blocked or covered over (Roll your mouse over the image to change it)

Watery fluid which is rich in nutrients is being produced inside the eye at all times. This fluid must constantly be returned to the bloodstream trough the eye’s drainage canal, called the trabecular meshwork. In the case of open-angle glaucoma, something has gone wrong in the drainage canal. When the fluid cannot drain fast enough, pressure inside the eye begins to build.

Symptoms of Angle-Closure Glaucoma:

The onset of acute Angle-Closure laucoma is typically rapid, constituting an emergency. If not treated promptly, this glaucoma produces blindness in the affected eye in three to five days. Symptoms may include:

  • Inflammation and pain
  • Pressure over the eye
  • Moderate pupil dilation that’s non-reactive to light
  • Cloudy cornea
  • Blurring and decreased visual acuity
  • Extreme sensitivity to light
  • Seeing halos around lights
  • Nausea and/or vomiting

Causes of Angle-Closure Glaucoma:

  • Defect in the eye structure
  • Anything that causes the pupil to dilate — dim lighting, dilation drops
  • Certain oral or injected medications
  • Blow to the eye
  • Diabetes-related growth of abnormal blood vessels over the angle

Diagnosing Angle-Closure Glaucoma:

Everyone should be checked for glaucoma at around age 35 and again at age 40. Those considered to be at higher risk for Angle-Closure glaucoma, including those who are Asian, farsighted or over the age of 60, should have their pressure checked every year or two.

Because of the rapid, potentially devastating results of Angle-Closure glaucoma, you should seek medical treatment immediately if you experience any of the above symptoms.

During eye exams, your doctor will use tonometry to check your eye pressure. After applying numbing drops, the tonometer is gently pressed against the eye and its resistance is measured and recorded.

An ophthaolmoscope can be used to examine the shape and color of your optic nerve. The ophthalmoscope magnifies and lights up the inside of the eye. If the optic nerve appears to be cupped or is not a healthy pink color, additional tests will be run.

Gonioscopy is used to determine whether the angle where the iris meets the cornea is open or closed, a key difference between open-angle glaucoma and Angle-Closure glaucoma.


Tonometry is used to check your eye pressure


An opthalmoscope is used to examine your optic nerve


Goniscopy is used to help your glaucoma type

Treatment for Angle-Closure Glaucoma:

Laser iridotomy is a common treatment for Angle-Closure Glaucoma. During this procedure, a laser is used to create a small hole in the iris, restoring the flow of fluid to the front of the eye. In most patients, the iridotomy is placed in the upper portion of the iris, under the upper eyelid, where it cannot be seen.


Laser iridotomy

Filtration surgery is performed when medicines and/or laser surgery are unsuccessful in controlling eye pressure. During this microscopic procedure, a new drainage channel is created to allow fluid to drain from the eye.