Chronic angle closure glaucoma

Chronic Angle-Closure Glaucoma is a type of glaucoma characterized by the gradual closure of the drainage angle of the eye, leading to increased intraocular pressure (IOP) and subsequent optic nerve damage. This condition is one of the major causes of blindness worldwide, particularly in Asian populations. Unlike its acute counterpart, chronic angle-closure glaucoma progresses slowly and can be asymptomatic for a long time, making early detection and management crucial.

Causes and Risk Factors

Chronic angle-closure glaucoma occurs when the anterior chamber angle of the eye, responsible for draining the aqueous humor, becomes progressively narrowed. This narrowing can be due to several factors, including anatomical predispositions (e.g., a shallow anterior chamber), aging, and certain medications. Risk factors for developing this condition include being of Asian descent, female gender, advanced age, and having a family history of glaucoma.

Symptoms

In its early stages, chronic angle-closure glaucoma may not present any symptoms. As the condition progresses, symptoms may include gradual loss of peripheral vision, eye pain, headache, nausea, and seeing halos around lights. However, these symptoms are often subtle and can be easily overlooked, which underscores the importance of regular eye examinations.

Diagnosis

Diagnosis of chronic angle-closure glaucoma involves a comprehensive eye examination, including tests to measure IOP, inspect the drainage angle (gonioscopy), assess the optic nerve damage (ophthalmoscopy), and test the visual field. Early detection is key to preventing irreversible vision loss.

Treatment

Treatment aims to reduce IOP and prevent further damage to the optic nerve. Options include medications (e.g., beta-blockers, prostaglandin analogs), laser therapy (laser peripheral iridotomy or laser trabeculoplasty), and surgical procedures (trabeculectomy, glaucoma drainage implants). The choice of treatment depends on the severity of the condition and the patient's overall health.

Prevention and Management

Regular eye exams are crucial for early detection and management of chronic angle-closure glaucoma, especially for individuals at higher risk. Lifestyle modifications and adherence to treatment plans can help manage IOP and minimize the risk of vision loss.