Treatment of Acute Glaucoma

About the disease

Acute glaucoma is an eye disease manifested by sharp increase of pressure in the eye. This pressure is also known as intraocular pressure. Its sharp increase can lead to vision deterioration or in some case even to vision loss. Increase in the intraocular pressure can develop if the fluid inside the eye does not flow out normally as it is supposed to or if it does not drain out properly. This can develop if the iris in the narrow angle becomes affected.

The most important measure in case a person has acute glaucoma is immediate medical intervention, otherwise there can be a nerve damage or vision loss. Most commonly, acute glaucoma progresses rapidly and the intraocular pressure needs to be stabilized as soon as possible as any delay in the treatment can be dangerous. Acute glaucoma is also more detrimental than chronic open-angle glaucoma, which develops gradually and thus, is more treatable at its beginning stages. Although, there is no known reason why acute glaucoma develops, age-related changes in the eye structure, which affect position of the iris and other anatomic structures of the eye, are believed to be the leading cause. Genetic predisposition can also cause development of acute glaucoma. People who are farsighted are more likely to develop acute glaucoma during their lifetime, as their eye angles are too narrow, which makes it more possible for an intraocular pressure to increase. Acute glaucoma is not very common accounting for less than 10% of all known glaucoma cases. Interesting fact: acute glaucoma is somewhat more common in Asia than in the USA where chronic open glaucoma is the most common type of this disease. This fact can be explained by the notion that Asians and other nations, such as Eskimos, have narrow angle eyes, which can lead to increase in the intraocular pressure in the elderly with predisposition to eye diseases.  

Symptoms

• Eye pain
• Headache
• Nausea
• Dizziness
• Uncontrollable tears
• Blurred vision, haloes
• Decrease in vision acuity

Diagnosis

• During a general examination an ophthalmologist will determine if there is any fluid flowing from the eye, which can be caused by increased intraocular pressure. A doctor can also use special drops to dilate the pupils, which allows to determine if the optic nerve was damaged.
• Gonioscopy is the most commonly used test for diagnosing acute glaucoma. A lens is placed into the eye to determine if the angle of the eye is drained. This test can also determine if an eye angle are narrowed or, on the other hand, if they are open. Gonioscopy can rule out other ophthalmologic diseases as well.
• Tonometry is a special test, which can measure the intraocular pressure in the eye. If it is twice the normal, a patient is most likely to have acute form of glaucoma.

Treatment

• Symptomatic treatment is used to reduce the intraocular pressure and to alleviate the symptoms of acute glaucoma, such as eye pain.
• A laser treatment is used to reduce the pressure in the eye as well by making the hole in the iris with a laser beam, which in some cases is used to reduce the narrowed angle of the eye as well.
• Surgical treatment also reduces the pressure in the eye and is primarily used in case if the laser beam couldn`t reach the iris for some reason.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko