Acute Angle Closure

Synonyms

Primary angle closure; Pupillary block

Definition

Acute apposition of the peripheral iris to the trabecular meshwork resulting in reduced drainage of aqueous humor leading to a rise of intraocular pressure.

Etiology

Narrow occludable angles, often in hyperopic eyes with smaller than average anterior segment dimensions.

Prophylaxis

Prophylactic iridotomy or iridectomy in the fellow eye of a patient who has suffered acute angle closure, or in eyes with an occludable angle in gonioscopy.

Clinical Presentation

Patients may be asymptomatic or present with a unilateral attack of decreased vision, blurring, and pain, often occurring during dim illumination. Occasionally patients will present with nausea and vomiting.

Diagnostics

An affected eye may show conjunctival hyperemia, corneal edema, shallow anterior chamber, and a mid-dilated pupil in a slit lamp examination. Tonometry will show a high intraocular pressure. Gonioscopic examination reveals angle closure with iridocorneal...