Glaucoma, or an increase in the intraocular pressure of the eye, can damage the optic nerve and result in permanent vision loss. According to the Merck Manual, acute angle-closure glaucoma, occurs in only 10 percent of glaucoma cases, in which there is a complete blockage of fluid drainage. Intraocular pressure rises rapidly and severe pain, redness and decreased vision can occur, along with headache and nausea.
Medications
Doctors prescribe medications to reduce intraocular pressure, or IOP, in angle-closure glaucoma. Some of these medications are eye drops that reduce the production of the fluid in the eye, including beta blockers, such as timolol, or cholinergics, such as pilocarpine .Other medications are taken by mouth, such as acetazolamide, which reduces fluid accumulation in the eye. Frequent administration, especially within the first few hours after angle closure first appears, helps decrease pressure before permanent damage occurs.
Laser Surgery
Laser peripheral iridotomy, or LPI, is performed once the inflammation in the eye subsides and the cornea clears, usually within a day or two. Both eyes receive treatment because there is a greater than 80 percent likelihood, according to the Merck Manual, that angle-closure glaucoma will occur in the other eye as well. LPI, done as an outpatient office procedure, opens a small hole in the side of the colored part of the eye, the iris, using a small laser beam of light. This helps fluid drain fluid from the eye, thereby lowering eye pressure. Blurry vision and irritation commonly occur for several days after the procedure.
Filtration Surgery
Filtration surgery, also called filtering microsurgery or trabeculectomy, is done in some cases of acute angle-closure glaucoma. The surgeon makes a small incision into the sclera, the white part of the eye, and removes a small part of the trabecular meshwork, which controls the flow of the liquid in the eye. This increases the flow of fluid and lowers eye pressure. Filtration surgery is done as an outpatient procedure and is successful for at least one year in 70 to 90 percent of older patients, the Glaucoma Research Foundation reports.
