Primary Angle Closure: A Silent Threat to Vision

     Primary angle closure refers to a physiological abnormality where the angle of the eye, responsible for draining aqueous humor from the anterior chamber and maintaining fluid balance, functions poorly. This leads to increased intraocular pressure (IOP) and raises the risk of acute angle closure crises and chronic angle closure glaucoma.

Causes

     Causes include congenital narrow angles (primary angle closure), often with genetic predisposition and more common among Asians, as well as secondary causes like cataracts or lens swelling pushing the iris forward.

Normal Function

     Under normal circumstances, the eye continuously produces aqueous humor, which flows from the posterior chamber (behind the iris) to the anterior chamber (in front of the iris). From there, it drains out through the angle of the eye via a sieve-like structure called the trabecular meshwork, where it is reabsorbed into the bloodstream.

Symptoms and Signs

     In the absence of acute IOP elevation, primary angle closure is typically asymptomatic and can only be detected during an eye exam using specialized techniques. These include slit-lamp biomicroscopy and contact gonioscopy, as well as additional diagnostic tools to confirm the condition and guide treatment.

Complications

• Acute Angle Closure Crisis: Sudden blurred vision, severe eye pain, redness, headache, nausea, and vomiting due to a rapid rise in IOP.
• Chronic Angle Closure Glaucoma: Gradual IOP increase over time, leading to progressive optic nerve damage. Both conditions can result in permanent vision loss if left untreated.

Prevention

     If a wide-angle closure is detected over more than 180 degrees, even without symptoms, preventive treatment with laser peripheral iridotomy is recommended. This procedure reduces the risk of acute angle closure crises and chronic angle closure glaucoma.

For more information, please contact:
 Ophthalmology Department, 1^st Floor, RAM 2 Hospital
Email: information@ram2-hosp.com
Line Official: @ram2
Tel: 02-032-3888

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