Topic Overview

Acute closed-angle glaucoma is an emergency situation. When fluid is suddenly blocked from draining out of the eye, pressure increases quickly, causing damage to the optic nerve. If acute closed-angle glaucoma is not treated, blindness develops rapidly.

• Several medicines may be needed to lower the intraocular pressure (IOP). Eyedrops that block the production of fluid (aqueous humor) are usually used first. If eyedrops do not lower the pressure, oral or intravenous (IV) medicines may be used.
• The drainage angle may be checked often using gonioscopy to monitor the effects of the medicines on the angle. See gonioscopy in the Exams and Tests section of this topic.
• If medicine does not lower the pressure, the person may need emergency laser treatment or surgery. Laser treatment or surgery creates a way for fluid to move easily from the back part (posterior chamber) to the front part (anterior chamber) of the eye.
• When medicine is able to lower the pressure, laser treatment (laser iridotomy) is commonly done 1 week later. Surgery (surgical iridectomy) is used for difficult cases. See the Surgery section of this topic.
• Although closed-angle glaucoma affects one eye first, the other eye often (about half of the time) develops the condition within 5 years.¹ For this reason, the other eye is examined and also treated with a laser to prevent the condition from developing in it.
• Ophthalmologists have been doing early cataract surgery to lower the risk of future attacks of acute closed-angle glaucoma. This treatment works, because removing the cataract creates more space in the front part of the eye. Having more space there makes it harder for the angle to close.