Glaucoma is an eye condition that can damage the optic nerve in the eye. The optic nerve in the eye is responsible for carrying visual messages to the brain. 

Optic nerve damage occurs due to increased pressure inside your eye (increased intraocular pressure). The damage to the optic nerve may lead to loss of vision or blindness, if not treated. If you start treatment early, you may be able to prevent vision loss and slow the progression of the disease.

Glaucoma is classified into various types, but these two are the most common:

  • Open-angle glaucoma
  • Acute angle-closure glaucoma (also known as narrow-angle closure glaucoma)

Keep reading to learn more about glaucoma, the differences between the various types of this eye condition, and treatment options that are available.

What is acute angle closure glaucoma?

Angle-closure glaucoma is also known as narrow-angle glaucoma, and is caused by a blockage of drainage canals in the eye. Blockage results in a sudden rise in pressure in the eye (intraocular pressure). Narrow-angle closure glaucoma is very rare. It can develop quickly and will need immediate medical treatment.

What is the difference between acute, narrow and open angle closure glaucoma?

Acute and narrow-angle closure glaucoma is the same. However, there is a difference between acute and open angle closure glaucoma. 

The differences between them include:

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Acute angle-closure glaucoma (narrow-angle closure glaucoma)Open angle closure glaucoma
In acute angle-closure glaucoma, the pressure in the eye increases suddenlyIn open angle closure glaucoma, the pressure in the eye builds gradually
Acute angle-closure glaucoma is a medical emergency and requires immediate medical attentionOpen angle closure glaucoma is not a medical emergency, but it requires medical attention
In acute angle-closure glaucoma, the symptoms flare up suddenlyOpen angle closure glaucoma is a slow progressive condition with few symptoms
Acute angle-closure glaucoma is not as common as open angle closure glaucomaOpen angle closure glaucoma is the most common form of glaucoma and is found in 90% of the people with the condition
Acute angle-closure glaucoma can cause blindness within days if not properly treatedOpen angle-closure glaucoma is a chronic disease, which if not treated, may lead to blindness, but it may take a couple of years
In acute angle-closure glaucoma, the aqueous humor is blocked completely, which causes a sudden spike in eye pressureIn open angle-closure glaucoma, the pressure in the eye builds gradually, and it increasingly pushes on the optic nerve, resulting in impaired vision

How is acute angle closure glaucoma treated with prescription medications in Canada?

If you experience acute closure angle glaucoma symptoms, immediately visit an eye doctor (ophthalmologist) or emergency room (ER). Your treatment must begin immediately as it may cause permanent blindness. Your eye doctor will use eye drops to reduce the increased intraocular pressure.

Once the eye pressure decreases, your doctor may perform laser iridotomy, a type of operation. The procedure involves using laser light to create a small hole in the iris, which is a part of your pupils that allows the drainage of the fluid.

Glaucoma medications in a nutshell

There are two types of medications that your eye doctor may use:

  • Those that decreases the amount of fluid that your eyes produce
  •  Those that narrow your pupil
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Various prescription medications for the treatment include:

  • Carbonic anhydrase inhibitors – Acetazolamide (decreases the fluid in your eye)
  • Steroids – Prednisolone (to reduce the inflammation)
  • Beta-blockers such as Timolol and Betaxolol (lowers the amount of fluid your eye produces)
  •  Miotics – Pilocarpine (opens the angle between your cornea and iris)
  • Alpha-adrenergic agents – Clonidine (lowers the eye pressure by decreasing the production of aqueous humor and increasing the outflow)
  • Hyperosmotic agents such as Glycerol and Mannitol (decrease the pressure by causing diuresis and reducing the volume)

Is acute angle closure glaucoma an emergency?

Acute angle closure glaucoma is serious as it can occur suddenly. Most people having the disease do not experience any symptoms.

An acute episode of acute angle glaucoma is considered a medical emergency. It would be best if you visited an eye doctor or ER immediately. If the pressure in the eye is not decreased quickly, there is a possibility that you may have permanent vision loss. 

How long does it take to go blind from acute angle closure glaucoma?

For most patients, acute angle closure glaucoma does not present any symptoms. In rare instances, the symptoms flare up suddenly, and you will need emergency treatment for the same. If not treated properly, acute angle closure glaucoma may cause blindness in the affected eye within 3-5 days. 

Does acute angle glaucoma go away?

If not treated immediately, the impact of acute angle closure glaucoma is irreversible. The first step of the treatment is to reduce the pressure in the eye.

Different medications help decrease elevated eye pressure and manage the symptoms. However, there is no cure for any glaucoma. Your eye doctor may also perform emergency surgery to treat the condition as soon as the pressure in the eye is decreased. 

What does acute glaucoma feel like?

Most of the time, people affected by acute angle closure glaucoma do not experience any symptoms. The pressure in the eye may increase drastically and within a short period. In the rare instance that symptoms are present, they may include: 

  • Headache (moderate to severe)
  • Eye pain
  • Blurred vision
  • Nausea
  • Red eyes
  • Halos around the lights
  • Mid-dilated pupil
  • Sudden loss of sight
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If you experience any symptoms, you should immediately visit an eye doctor or a local emergency room. 

What causes acute glaucoma?

The following are some of the causes that may trigger or cause acute glaucoma:

  • Certain medications (antidepressants, antihistamines, sulfonamides, phenothiazines, or cold medications)
  • Family history
  • Certain health conditions (cataracts, Diabetic neuropathy, tumors, ocular ischemia, eye inflammation)
  • Age
  • Farsightedness
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