Last reviewed: November 2017
Last updated: August  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • halos around lights
  • aching eye or brow pain
  • headache
  • nausea, vomiting
  • reduced visual acuity
  • eye redness
  • elevated intraocular pressure (IOP)
  • corneal oedema
  • fixed dilated pupil

Other diagnostic factors

  • incidental eye findings
  • blurred vision
  • change in vision

Risk factors

  • female gender
  • hyperopia
  • shallow peripheral anterior chamber
  • second eye having angle closure
  • Inuit and Asian ethnicity
  • advanced age
  • FHx
  • use of medications that induce angle narrowing

Diagnostic investigations

1st investigations to order

  • gonioscopy, examination of anterior chamber angle
  • slit-lamp examination
  • automatic static perimetry
Full details

Investigations to consider

  • ultrasound biomicroscopy
  • anterior segment optical coherence tomography (of angle)
  • evaluation of the optic nerve head by fundoscopy
  • retinal optical coherence tomography
  • Heidelberg's retinal tomography
  • GDx nerve fibre analyser
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Clinical Professor

Department of Ophthalmology

Keck School of Medicine

University of Southern California

Los Angeles

CA

Disclosures

AK declares that she has no competing interests.

Riffenburgh Professorship in Glaucoma

Associate Professor of Ophthalmology

Doheny Eye Institute

Department of Ophthalmology

Keck School of Medicine

University of Southern California

Los Angeles

CA

Disclosures

BAF declares that he has no competing interests.

Dr Ani Khondkaryan and Dr Brian A. Francis would like to gratefully acknowledge Dr Yaniv Barkana and Dr Noa Chetrit, previous contributors to this monograph. YB and NC declare that they have no competing interests.

Peer reviewers VIEW ALL

Consultant Ophthalmic Surgeon

King's College Hospital

Honorary Research Fellow

Institute of Ophthalmology

London

UK

Disclosures

GG declares that he has no competing interests.

Associate Professor of Ophthalmology

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

Cole Eye Institute

Cleveland Clinic

Cleveland

OH

Disclosures

EJR has received one honorarium from Pfizer, Inc. (manufacturers of Xalatan) for a speaking engagement.

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