Acute Angle-closure Glaucoma

Narrow Angle Glaucoma

What is acute glaucoma?

Glaucoma is an eye disease characterized by rapid onset of increased pressure within the eye. Acute glaucoma occurs in individuals with specific abnormal eye anatomy that can result in trapped fluid inside the eye. When the pupil dilates, the iris obstructs the angle of the anterior chamber, where the eye's fluid normally drains out. This results in a rapid rise in pressure within the eye.

If not treated promptly, acute glaucoma may cause permanent loss of vision. Closed angle glaucoma is much less common than open angle glaucoma. It is most commonly seen in older age groups.

Acute Angle-closure Glaucoma signs and symptoms

  • Severe, throbbing eye pain and headache.
  • Redness in the eye.
  • Blurred vision or halos around lights.
  • Tender, firm eyeball.
  • Dilated, fixed pupil.
  • Nausea, vomiting and weakness may sometimes occur due to severe eye pain.

How is it diagnosed?

History includes headache, blurred vision with halos around lights, and a red painful eye. Pain may be severe and may be accompanied by nausea and vomiting.

Physical exam shows a red eye with a dilated pupil.

Tests measuring intraocular pressure will be quite high.

How is Glaucoma treated?

An acute attack is treated by lowering eye pressure with oral and/or intravenous medication. When the eye has stabilized, laser incision of the iris (iridotomy) or removal of part of the iris (iridectomy) is performed. This usually prevents any further attacks.

Additional Information


  • While hospitalized, medications to control the pressure will be given intravenously.
  • After surgery, eye drops may be needed to lower pressure inside the eye. Follow the instructions and schedule carefully, even if symptoms subside or the eye drops are occasionally uncomfortable.
  • Diuretics to decrease fluid pressure in the eye.

Diamox (Acetazolamide), Imuran (Azathioprine)


After treatment, resume your normal activities gradually and avoid fatigue.

What might complicate it?

Acute angle-closure glaucoma may be secondary to anterior uveitis or dislocation of the lens.

Predicted outcome

Untreated glaucoma may result in severe and permanent visual loss within two to five days of onset of symptoms. Laser iridectomy will usually result in permanent cure.


Inflammation of the iris (uveitis), conjunctivitis, and corneal disorders are differential diagnoses.

Appropriate specialists


Notify your physician if

  • You or a family member has symptoms of acute glaucoma. This is an emergency!