Unlike POAG (Primary Open-Angle Glaucoma), where the IOP increases slowly, in intense angle-closure, it enhances all of a sudden. This unexpected rise in pressure can happen within a matter of hours and become really unpleasant. If the pressure rises high enough, the pain might end up being so extreme that it can trigger nausea and vomiting.
The eye becomes red, the cornea swells and clouds, and the patient might see haloes around lights and experience blurred vision.
Acute Glaucoma Attack Definition
An intense attack is an emergency condition. If treatment is postponed, eyesight can be completely damaged. Scarring of the trabecular meshwork might occur and result in chronic glaucoma, which is much more difficult to manage. Cataracts may likewise develop. Damage to the optic nerve might take place rapidly and cause permanently impaired vision.
A lot of these unexpected attacks take place in darkened rooms, such as movie theaters. If you recall, darkened environments cause the pupil to dilate, or increase in size. When this occurs, there is optimal contact in between the eye ´ s lens and the iris. This additional narrows the angle and might trigger an attack. But the pupil likewise dilates when one is thrilled or nervous. Consequently, many intense glaucoma attacks take place during periods of stress. A range of drugs can also cause dilation of the pupil and lead to an attack of glaucoma. These consist of anti-depressants, cold medications, antihistamines, and some medications to deal with nausea.
Severe glaucoma attacks are not constantly complete blown. Often a patient may have a series of small attacks. A slight blurring of vision and haloes (rainbow-colored rings around lights) might be experienced, however without pain or soreness. These attacks may end when the patient gets in a well lit space or goes to sleep– two scenarios which naturally trigger the pupil to constrict, therefore permitting the iris to retreat from the drain.
How to Treat Acute Glaucoma Attack
An intense attack may be stopped with a combination of drops which constrict the pupil, and drugs that help in reducing the eye ´ s fluid production. As soon as the IOP has dropped to a safe level, your ophthalmologist will perform a laser iridotomy. A laser iridotomy is an outpatient treatment where a laser beam is made use of making a little opening in the iris. This allows the fluid to flow more easily. Drops will be made use of to anesthetize your eye and there is no pain involved. The whole treatment should take less than thirty minutes. Laser surgery might be performed prophylactically on the other eye, as well. Considering that it is common for both eyes to suffer from narrowed angles, operating on the unaffected eye is done as a preventive procedure.
There is no curative medical treatment for acute angle-closure glaucoma. An eye doctor should treat angle-closure glaucoma with either laser therapy or incisional medical therapy. Using eyedrops, oral medications (osmotic agents such as glycerol or carbonic anhydrase inhibitors such as Diamox [acetazolamide], or intravenous medication (mannitol, an osmotic drug) are temporizing measures developed to bring the pressure down prior to surgical treatment.
Regular examinations using a technique called gonioscopy can forecast one’s opportunities of having an acute attack. An unique lens which includes a mirror is positioned gently on the front of the eye and the width of the angle examined aesthetically. Patients with slim angles can be alerted of early symptoms, so that they can seek instant treatment. In many cases, laser treatment is advised as a preventive step.
Not all angle-closure glaucoma victims will experience a severe attack. Instead, some may establish what is called persistent angle-closure glaucoma. In this case, the iris progressively closes over the drain, triggering no overt symptoms. When this takes place, scars gradually form in between the iris and the drain and the IOP will not rise till there is a substantial amount of scar tissue formed– sufficient to cover the drainage area. If the patient is treated with medication, such as pilocarpine, an intense attack may be prevented, however the chronic kind of the disease might still develop.