Acute Angle-Closure Glaucoma (AACG)

Updated: Mar 27, 2025
  • Author: Albert P Lin, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Overview

Background

Angle closure is defined as the apposition of iris to the trabecular meshwork, which results in increased intraocular pressure (IOP). In acute angle closure (AAC), the process occurs suddenly with a dramatic onset of symptoms, including blurred vision, red eye, pain, headache, and nausea and vomiting. The sudden and severe IOP elevation can quickly damage the optic nerve, resulting in acute angle-closure glaucoma (AACG).

AAC is a true ophthalmic emergency, and a delay in treatment can result in blindness. While immediate treatment can sometimes minimize the amount of visual loss, the best treatment is to stop its occurrence in susceptible individuals. [1, 2, 3, 4]

Pathophysiology

Primary angle-closure glaucoma (AAC) is uncommon in younger individuals but becomes more prevalent with age as the lens enlarges and potentially pushes the iris forward, narrowing the angle between the iris and the cornea. [5] This condition is influenced by several risk factors including genetic predisposition, advanced age, and ethnicity, with increased incidence noted in Asian and Inuit populations, and decreased incidence in European and African populations.

Clinically, narrow angles reduce the space between the iris at the pupil and the lens. During mid-dilation of the pupil, this space is minimized, facilitating contact between the iris and lens.

 
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