Section 9-C: Diagnosis of acute angle closure glaucoma
Acute angle closure glaucoma can be diagnosed with an examination by an eye doctor. Some of the common signs of acute angle closure may be recognized by examination of the eye (Table 9-3).
Pupillary block and obstruction of the drainage angle causes the iris to bow forward, which can be recognized with a slit lamp exam by an eye doctor (Figure 9-2). This abnormal configuration of the iris and cornea blocks outflow of fluid from the eye and causes the IOP to become rapidly elevated.
Figure 9-2. Abnormal forward bowing Iris characteristic of acute angle closure glaucoma. A key feature of acute angle closure glaucoma is the abnormal forward position of the iris. Forward bowing of the iris may be observed by an eye doctor with a slit lamp examination. When a straight beam of light is projected on an eye with acute angle closure glaucoma, the beam (indicated by an arrow) appears curved due to the forward bowing of the iris.
When the IOP becomes very high, the “whites” of the eyes become red. High IOP also causes the normally clear cornea to become hazy which results in significant decreases in vision. Changes in the cornea may also cause patients to see halos around bright objects. Finally, high IOP may cause the pupil to become partially dilated and poorly responsive to light (Figure 9-3).
Figure 9-3. Acute Angle Closure Glaucoma: External Appearance. Blockage of the drainage angle causes IOP to rise. High pressure results in a constellation of signs seen in acute angle closure glaucoma including redness of conjunctiva (red arrow), haziness of the cornea, and a mid-dilated pupil (white arrow).
Rapid elevation of IOP is a key feature of acute angle closure glaucoma. The pressure may rise as high as four times normal and can cause permanent and significant vision loss. Consequently, it is crucial to treat acute angle closure glaucoma promptly.
| Table 9-3. Signs of acute angle closure glaucoma. These findings of acute angle closure glaucoma are seen in an examination by an eye doctor. |
| Cloudy cornea |
| Red eyes |
| Forward bowing iris (narrow drainage angle) |
| Mid-dilation of the pupil |
| High intraocular pressure (as high as 4X normal pressure) |
Pupillary block and obstruction of the drainage angle causes the iris to bow forward, which can be recognized with a slit lamp exam by an eye doctor (Figure 9-2). This abnormal configuration of the iris and cornea blocks outflow of fluid from the eye and causes the IOP to become rapidly elevated.
Figure 9-2. Abnormal forward bowing Iris characteristic of acute angle closure glaucoma. A key feature of acute angle closure glaucoma is the abnormal forward position of the iris. Forward bowing of the iris may be observed by an eye doctor with a slit lamp examination. When a straight beam of light is projected on an eye with acute angle closure glaucoma, the beam (indicated by an arrow) appears curved due to the forward bowing of the iris.
When the IOP becomes very high, the “whites” of the eyes become red. High IOP also causes the normally clear cornea to become hazy which results in significant decreases in vision. Changes in the cornea may also cause patients to see halos around bright objects. Finally, high IOP may cause the pupil to become partially dilated and poorly responsive to light (Figure 9-3).
Figure 9-3. Acute Angle Closure Glaucoma: External Appearance. Blockage of the drainage angle causes IOP to rise. High pressure results in a constellation of signs seen in acute angle closure glaucoma including redness of conjunctiva (red arrow), haziness of the cornea, and a mid-dilated pupil (white arrow).
Rapid elevation of IOP is a key feature of acute angle closure glaucoma. The pressure may rise as high as four times normal and can cause permanent and significant vision loss. Consequently, it is crucial to treat acute angle closure glaucoma promptly.
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