Glaucoma is a disease of the eye usually associated with elevated pressure that if left untreated will cause progressive loss of vision and ultimately blindness. Narrow angle glaucoma is a less common type of glaucoma usually effecting both eyes with a hereditary influence. In this type of glaucoma the fluid inside the eye known as aqueous is not able to be reabsorbed due to a blockage at the drainage site known as the trabecular meshwork. As the fluid backs up inside the eye it leads to the pressure elevation. Narrow angle glaucoma increases with age with it being most prevalent in the sixth decade of life. It is more common in females and in patients who are hyperoptic, or far sighted.

With age the lens inside your eye tends to grow and the pupils become smaller. In some patients this could lead to a pupillary block of the flow of fluid to the drainage sight. This can occur due to minor events such as dilation of the pupil or in dim illuminations such as a movie theater. The patients can complain of very intense pain around the eye or behind the eye. There may be a significant amount of blurred vision with colored halos around lights. Headaches can be also in the frontal area and there may be nausea and also vomiting. During the acute attack the pressure in the eye may become so elevated that damage to the optic nerve with considerable loss of vision can occur fairly quickly.

The treatment of narrow angle glaucoma involves one breaking the attack. This can be done as an outpatient with a number of medications. The definitive treatment is to create a new opening in the iris to allow the passage of the fluid to the drainage site. This is known as a peripheraliridectomy. A laser procedure is done in the office to perform this. Generally the other eye is also at high risk for developing the same problem and typically the peripheraliridectomy is also performed in fellow eye.

Generally patients if they are caught at an early stage of the attack the proper treatment can be started and these patients can be cured of their glaucoma. However, other patients may have damage to the optic nerve or other parts of the eye and end up with secondary types of glaucoma.

Patients at high risk for developing this type of glaucoma need to be concerned about systemic medications including non prescription preparations that carry warnings about glaucoma. These medications have the potential to induce angle closure glaucoma and even a minimal dilation of the pupil can precipitate an attack. Those patients at risk need to be knowledgeable about this problem.

Laser surgery can be done as an out patient and is highly effective in treating this problem.