Glaucoma is also known as the “silent thief of sight” because it develops slowly and gradually. The signs of glaucoma go unnoticed until they cause significant damage to the eyes. In the United States, glaucoma is the second most common reason for blindness. There are many types of glaucoma, of which angle closure glaucoma is the most serious one and requires immediate medical attention. In today’s post, we will understand the early signs and symptoms of angle closure glaucoma to prevent permanent vision loss and seek medical attention on time.
What is Angle Closure Glaucoma?
Before jumping to signs & symptoms of angle closure glaucoma, it’s important to understand what angle closure glaucoma is. Angle-closure glaucoma is the condition when fluid in the eye stops draining or is unable to drain properly due to the drainage angle formed by the cornea and the iris becomes blocked.
As fluid could not drain properly due to blockage the condition led to a sudden increase in intraocular pressure. Due to high intraocular pressure optic nerves can damage and it can lead to permanent vision loss if not treated on time.
Angle Closure Glaucoma can become a medical emergency as it can develop rapidly. It can be acute (sudden onset) or chronic (slow progression) but in both conditions, early detection will play a vital role in treatment.
Why is Angle Closure Glaucoma a Medical Emergency?
Angle-closure glaucoma requires immediate attention and is particularly dangerous. When the intraocular pressure rises in the eye it causes irreversible damage to the optic nerve. If the condition is not treated on time (within hours), then the patient can loss vision permanently. When compared to open-closure glaucoma which also develops more gradually, angle closure glaucoma requires immediate medical attention to protect against vision loss.
Top 10 Signs & Symptoms of Angle Closure Glaucoma
1. Severe Eye Pain
One of the most common and hallmark symptoms of angle closure glaucoma is severe and sudden pain in the eye. Individuals will feel deep pain with increased pressure within the eye, throbbing ache, and redness in a few cases. In a few cases, the pain can radiate up to the jaws, forehead or temples. The condition is due to a sudden increase in intraocular pressure. Due to increased intraocular pressure, eye can also be swollen or distended in case of angle closure glaucoma condition.
If you notice any of the symptoms, seek immediate medical attention. Early intervention by doctors can help prevent permanent damage to your vision.
2. Blurred Vision
Another common symptom of angle closure glaucoma is blurred or hazy vision. The increased pressure inside the eye distorts the shape of the eye which results in a decreased ability to focus properly. Due to this, you will find difficulty seeing clearly and your vision will become foggy even if you are using the corrective lens.
If you notice your vision has become suddenly blurred along with other symptoms like redness in the eye, swelling, eye pain or nausea, then it could be a potential sign of angle closure glaucoma.
3. Nausea & Vomiting
Due to increased intraocular pressure, many people with acute closure glaucoma condition will experience nausea & vomiting due to severe pain in the eye. The increased intraocular pressure causes significant discomfort in the whole body. The symptoms of angle closure glaucoma are often mistaken for migraine or other conditions but it is important to seek medical attention when such symptoms appear.
If you feel nauseous or vomit after eye pain or blurred vision, do not ignore these symptoms and go to your health advisor or hospital immediately to seek immediate medical attention.
4. Rainbow-Hued Halos Around Lights
People with angle closure glaucoma see rainbow-coloured halos around lights at night. This is due to high eye pressure, which scatters light entering the eye. As a result, whenever you see an object with light, such as a headlamp, bulb, street lamp, or any other light source, you will see colorful rings around the light. These halos cause vision disturbance and can be quite alarming.
If you notice halos around light especially at night or in low light conditions and also notice other symptoms like nausea, redness in the eyes, swelling or pain in the eye, then it’s time to see your eye doctor at earliest.
5. Redness of the Eye
Redness in the eye is another common and major symptom of angle closure glaucoma. With the increased intraocular pressure inside the eye, the blood vessels inside the eye dilate causing a bloodshot or red appearance in the whites of the eyes. The redness inside the eye can extend up to another eye depending upon the severity of the condition.
Apart from angle closure glaucoma, several other reasons can cause red eyes, such as blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, chemical burn, and scleritis.
6. Headaches
Research has showcased the evidence of headaches as a symptom of angle closure glaucoma. As the pressure inside the eye increases, it radiates to the head and causes severe headaches. The pain caused by these headache episodes can be throbbing and extend around the eyes or forehead. Due to the increased severity of pain, people often mistake it for a migraine.
If you are having headaches and other associated symptoms of angle closure glaucoma such as blurred vision, eye pain or nausea, then it is essential to seek medical attention right away.
7. Decreased Peripheral Vision
As angle closure glaucoma progresses, it starts impacting your ability to see objects outside of your direct line of sight i.e it impacts your peripheral vision. In the early stage, you won’t be able to notice the changes but as angle glaucoma progresses peripheral vision loss advances. Due to peripheral vision loss, you will face trouble in seeing things which are out of the corner of your eyes and it could be a strong indication of angle closure glaucoma.
8. Sudden Loss of Vision
Sudden loss of vision can also occur in acute cases of angle closure glaucoma. Vision loss can occur in one eye or both eyes. Along with vision loss, the patient may experience severe eye pain and other symptoms. The main reason for vision loss in angle-closure glaucoma is damage to the optic nerve caused by increased intraocular pressure. Once the optic nerve is damaged, it stops transmitting visual information to the brain and the person loses vision. If the condition is not treated on time, vision loss can be permanent.
If you are experiencing sudden vision loss, seek immediate medical attention to prevent permanent damage to your eyes.
9. Photophobia (Sensitivity to Light)
Photophobia or increased sensitivity to light is another common symptom of angle closure glaucoma. People affected with angle closure glaucoma feel pain in their eyes when looking at the bright light source such as the sun or any other artificial lightning. Increased sensitivity to the lights makes it difficult for people to function in a well-lit environment and find discomfort when working outside or in a sunny environment.
10. Eyelid Swelling
Due to increased intraocular pressure inside the eye, swelling in the eyelid area is observed. At first, the swelling is subtle but becomes noticeable as the condition worsens. In a few cases, due to the increase in pressure, the eye causes fluid retention and inflammation which cause puffiness around the eyes and you will feel heaviness around the eye.
Why Does Early Detection Matter for Angle Closure Glaucoma?
person affected with Angle-closure glaucoma requires immediate medical attention because it is an urgent condition. If the condition is not treated on time then it can cause permanent vision loss. The increased pressure inside the eye for a longer duration causes damage to irreversible damage to the optical nerve and can lead to permanent vision loss.
If you notice any of the angle closure glaucoma symptoms then it is necessary to the patient to the doctor so that they can lower the intraocular pressure and minimize the damage.
How is Angle Closure Glaucoma Diagnosed?
Your eye surgeon can use different methods to diagnose angle closure glaucoma if you are experiencing any symptoms. Your doctor will perform a thorough eye examination to confirm the presence of angle closure glaucoma. The diagnostic method includes:-
a. Tonometry:- This method is used to measure the pressure inside the eyes.
b. Gonioscopy:- It is used to assess the drainage by examining the angle between the iris and cornea.
c. Ophthalmoscopy:- The method involves examination of the optic nerve to check damages and other signs of angle closure glaucoma
d. Visual Field Testing:- This test is required to check any peripheral vision loss.
Apart from the above tests, your eye doctor will check other risk factors such as age, genetic history, and any previous eye condition which can lead to the risk of developing angle closure glaucoma.
What are the treatment options for Angle Closure Glaucoma?
The primary goal of the angle closure glaucoma treatment is to reduce the intraocular pressure as soon as possible to prevent any further damage to the optic nerve and save the vision loss. The treatment options include:-
a. Medication
To bring down the intraocular pressure rapidly your eye doctor will prescribe oral medications such as oral carbonic anhydrase inhibitors, intravenous hyperosmotic agents, and topical beta-blockers may be administered. These medicines help in lowering the intraocular pressure, relieving the symptoms and giving time to prepare for the definitive treatment.
b. Laser Therapy
There are two types of laser therapy which can be performed depending on the condition:-
- Laser Peripheral Iridotomy: In this procedure, a small hole is created in the peripheral iris using the laser. The hole created allows fluid to drain more efficiently from the eye and immediate relief is obtained.
- Laser Iridoplasty: In a few cases where the isis is very closed, laser iridoplasty is performed to push the iris away from the angle and as a result it improves draining.
c. Surgery
In some cases where laser treatment is also insufficient, your eye surgeon will perform surgery to permanently alter the eye structure to improve fluid drainage.
Can Angle Closure Glaucoma Be Prevented?
No, Angle-Closure Glaucoma can’t be prevented. However certain risk factors such as drainage angle, family history, age, or any other eye injury can increase the likelihood of developing angle-closure glaucoma. People with the risk of developing angle-closure glaucoma should get their eyes regularly checked to see any signs of glaucoma or any other related eye diseases.
In a few cases, laser iridotomy can be used as a preventive method to reduce the risk of developing acute angle-closure glaucoma.
Conclusion
Angle-closure glaucoma is a serious eye condition and should be treated immediately. Any delay in treatment can lead to permanent vision loss. Recognizing the top 10 signs & symptoms of angle closure glaucoma such as severe eye pain, redness, swelling, nausea, halos around light etc. helps in early intervention and treatment.
If you are experiencing any symptoms shared in this article then seek immediate medical attention to protect your vision.
1. What are the advanced symptoms of glaucoma?
Advanced-level symptoms of glaucoma include severe vision loss, blurred or hazy vision, halos around lights, loss of contrast sensitivity, severe eye pain, redness in the eye, nausea & vomiting, and sudden vision changes.
2. How quickly do glaucoma symptoms develop?
Development of glaucoma symptoms depends upon the type of glaucoma:-
a. Primary Open-Angle Glaucoma: It is the most common type of glaucoma & symptoms develop very slowly. The development of symptoms is so slow that it takes months or years to notice the changes. Due to late diagnosis, severe damage to the optic nerve has already occurred.
b. Angle-Closure Glaucoma:- Angle-closure glaucoma symptoms develop at a very fast rate and become noticeable after a few hours. Angle-closure glaucoma symptoms require immediate medical intervention to prevent permanent vision loss.
c. Normal-Tension Glaucoma: The symptoms for this type of glaucoma develop very slowly similar to primary open-angle glaucoma symptoms. It often takes a year to notice but still damages the optical nerve over time.
d. Secondary Glaucoma:- This type of glaucoma is developed due to other conditions like injury, trauma, infection, medications, etc. The symptoms depend upon the condition.
3. Can glaucoma cause eye pain?
Yes, glaucoma can cause severe eye pain.
4. Does glaucoma always show symptoms in the early stages?
No, glaucoma does not show early-stage symptoms and due to this they often go unnoticed for months. However, in the case of angle-closure glaucoma, symptoms are visible in a few hours.
Regular eye examination is necessary to detect early symptoms and treatment.
5. Can glaucoma symptoms appear in one eye only?
Yes, glaucoma symptoms can appear in one eye only but it can affect both eyes. There are many cases when the glaucoma symptoms are visible in one eye but it affects both eyes.
6. Is blurred vision a definitive sign of glaucoma?
No, blurred vision is not the definitive sign of glaucoma. However, blurred vision is one of the signs of glaucoma but it is not the definitive or early signs of glaucoma.
7. Can glaucoma cause halos around lights?
Yes, halos around light is one of the most common symptoms of angle closure glaucoma.
8. How do I differentiate between glaucoma and cataracts?
Glaucoma & Cataracts are both eye conditions that affect vision, however, both of them have different causes & symptoms. Cataracts are caused when the natural eye lens becomes cloudy. The condition occurs mostly due to ageing. On the other side, glaucoma is caused due to increased pressure inside the eye.
Reviewed By
Dr. Sonam Aggarwal
lMBBS, MD(C.Medicine)