Primary Angle Closure Glaucoma

By Medically reviewed by hellodoktor


What is primary angle closure glaucoma?

Primary angle closure glaucoma is a closed angle type of glaucoma. In this condition, the iris blocks the drainage of the eye through the trabecular meshwork. It is primary glaucoma because there is no known cause relating to another condition, although the problem itself is clearly visible and related to the depth of the drainage angle of the eye (which is narrow). It includes acute angle closure glaucoma (previously called acute glaucoma) and chronic angle closure glaucoma.

How common is primary angle closure glaucoma?

In people aged 40 years and older, it is estimated that there are 0.69% in 2010, which is estimated to be over 15 million in 2010. By 2020, the number of patients with primary angle closure glaucoma in the world may increase to over 21 million.

However, it can be managed by reducing your risk factors. Please discuss with your doctor for further information.


What are the symptoms of primary angle closure glaucoma?

Acute primary angle closure glaucoma tends to be very painful because the rise in pressure happens suddenly. Symptoms include seeing halos around light sources, eye redness, cloudy vision and, sometimes, sickness. It must be treated straight away and in most cases, vision recovers completely.

Sometimes people experience a series of mild attacks of angle-closure glaucoma. These are called sub-acute attacks and often occur in the evening. Vision may seem misty, with colored rings around white lights and there may be some discomfort and redness in the eye. If you have these symptoms, you should consult your optometrist without delay.

Chronic angle closure glaucoma develops slowly, usually without symptoms.

When should I see my doctor?

Early diagnosis and treatment can stop primary angle closure glaucoma from worsening and prevent another medical emergency, so talk to your doctor as soon as possible to prevent this serious condition.

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes primary angle closure glaucoma?

In primary angle closure glaucoma, the trabecular meshwork is too narrow. The function of this meshwork is to control the fluid pressure in the eyes. There are many causes for this narrowing:

  • Pressure differences: This includes a pressure difference between the back of the eye (posterior chamber) and the front of the eye (anterior chamber).
  • Anatomical changes: If the part of the eye that creates fluid is bigger than normal, the increase in fluid can change the pressure in the eyes. The position of the iris relative to the ciliary body, the volume of the iris, and the shape, position, and thickness of the lens, all can contribute to angle narrowing.

Some of these anatomical features change with age, such as the thickness of the lens, which increases as we get older (forming cataracts). This is why sometimes patients develop progressive angle narrowing over time.

In other situations, the condition can happen acutely, resulting in an acute angle-closure crisis. This is a very worrisome situation in which the eye pressure rapidly increases and vision can be severely affected.

Risk factors

What increases my risk for primary angle closure glaucoma?

This sort of glaucoma is less common in Western countries and more often found in people of Asian origin. It may be acute (sudden onset) or chronic (slowly developing).

Other risk factors include:

  • Age: Acute and chronic angle closure become much more common with increasing age. It is uncommon below the age of 40.
  • Sex: Women suffer from acute and chronic angle closure more frequently than men.
  • Ethnicity: If you are of Asian origin you are more at risk of angle closure glaucoma than someone of European origin. It may also come on at a younger age and be more severe.
  • Family history: If you have glaucoma, your close relatives have an increased chance of developing the condition. You should advise members of your family to have regular eye checks by an optometrist (optician).
  • Long sight: People with a high degree of long sight are more prone to angle closure glaucoma.

Diagnosis & Treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.


How is primary angle closure glaucoma diagnosed?

During your eye examination, your eye doctor will assess all parts of the eyes as they would during a comprehensive eye examination. In addition, your doctor will perform gonioscopy, which uses a special mirror in order to visualize the angle. Sometimes, imaging of the front part of the eye, called anterior segment optical coherence tomography, or ultrasound biomicroscopy (a special type of ultrasound eye exam) will be performed to more specifically determine the anatomy of the angle.

How is primary angle closure glaucoma treated?     

After your eye examination, your ophthalmologist will discuss any recommendations for laser iridotomy, medications, or surgery, which will briefly be discussed below.

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage primary angle closure glaucoma?

It is considered that there are some home remedies to prevent this condition.

  • Eat a healthy diet: Eating a healthy diet can help you maintain your health, but it won’t prevent this condition from worsening. Several vitamins and nutrients are important to eye health, including those found in dark, leafy greens and fish high in omega-3 fatty acids.
  • Exercise safely: Regular exercise may reduce eye pressure. Talk to your doctor about an appropriate exercise program.
  • Limit your caffeine: Drinking beverages with large amounts of caffeine may increase your eye pressure.
  • Sip fluids frequently: Drink only moderate amounts of fluids at any given time during the course of a day. Drinking a quart or more of any liquid within a short time may temporarily increase eye pressure.
  • Sleep with your head elevated: Using a wedge pillow that keeps your head slightly raised, about 20 degrees, has been shown to reduce intraocular eye pressure while you sleep.
  • Take prescribed medicine: Using your eye drops or other medications as prescribed can help you get the best possible result from your treatment. Be sure to use the drops exactly as prescription. Otherwise, your optic nerve damage could get even worse.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: March 12, 2017 | Last Modified: September 13, 2019

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