6.20 : Angle Closure Glaucoma: Treatment

In angle‐closure glaucoma, the bulged iris results in  a closed iridocorneal angle, effectively occluding the Schlemm's canal.

The obstruction halts aqueous humor outflow, leading to a sudden increase in the intraocular pressure. This triggers acute symptoms such as nausea, eye congestion, vomiting and severe headache.

Treatment of angle-closure glaucoma involves both short-term medical management and long-term surgical route.

Short-term emergency treatment is aims to lower the acute intraocular pressure prior to surgery.

For example, pilocarpine, a cholinomimetic drug, effectively increases the aqueous humor drainage by opening the trabecular meshwork.

However, its prolonged usage may result in side effects such as blurred vision and night blindness.

Long-term treatment for angle-closure glaucoma comprises laser and surgical procedures.

In laser iridotomy, a laser beam is used to create a hole in the iris. This restores the conventional path for aqueous humor outflow via the trabecular meshwork.

In trabeculectomy, an alternative path is created surgically to allow the outflow of aqueous humor, bypassing the blocked iridocorneal angle.