ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferencesView all Images (5)
Emergency: requires immediate attention
Acute angle-closure glaucoma - External and Internal Eye
Print
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Acute angle-closure glaucoma - External and Internal Eye

Print Images (5)
Contributors: Rachel Ellis MD, Andrew Goodfriend MD, Lauren Patty Daskivich MD, MSHS, Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD
Other Resources UpToDate PubMed

Synopsis

Angle-closure glaucoma is a major cause of blindness worldwide. White individuals have a 0.1% incidence of acute angle-closure glaucoma, while those of Eskimo descent have up to 40 times this rate. Angle-closure glaucoma is also more common in persons aged 55-70, women, Asians, and individuals with smaller eyes. Many drugs, including anticholinergic agents, tricyclic antidepressants, selective serotonin reuptake inhibitors, and adrenergic agonists, can precipitate angle-closure glaucoma by shifting the lens iris diaphragm anteriorly.  

An attack of angle-closure glaucoma occurs when there is a sudden obstruction of aqueous humor outflow through the drainage angle of the eye, causing a rapid increase in intraocular pressure. Primary angle closure may be caused by pupillary block or angle crowding or both. Pupillary block occurs when the increased iris convexity brings the iris into apposition with the trabecular meshwork, thereby blocking drainage of the aqueous fluid. With angle-crowding mechanism, anteriorly positioned ciliary processes push the iris anteriorly so that the peripheral iris lies against the trabecular meshwork. Secondary angle closures are associated with other ocular diseases such as iris neovascularization, uveitis, trauma, or lens protein leakage.

Patients often present with acutely painful, blurred vision associated with a red eye. Headache, seeing rainbow-colored halos around lights, nausea, and vomiting may also be present. There may be a recent history of physiologic or pharmacologic pupillary dilation.

Codes

ICD10CM:
H40.219 – Acute angle-closure glaucoma, unspecified eye

SNOMEDCT:
30041005 – Acute angle-closure glaucoma

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Updated: 11/16/2016
Copyright © 2018 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Acute angle-closure glaucoma - External and Internal Eye
Print 5 Images
View all Images (5)
(with subscription)
Acute angle-closure glaucoma : Eye pain, Headache, Nausea/vomiting, Afferent pupillary defect, Corneal edema, Ocular hypertension, Shallow anterior chamber, Conjunctival injection, Mydriasis, Blurry vision, Sudden onset of visual loss
Clinical image of Acute angle-closure glaucoma
Copyright © 2018 VisualDx®. All rights reserved.