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Medical Author:

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Angle closure may occur two ways:

• The iris may be pushed forward up against the trabecular meshwork.
• The iris may be pulled up against the trabecular meshwork.

In either case, the position of the iris causes the normally open anterior chamber angle to close. Aqueous humor that should normally drain out of the anterior chamber is trapped inside the eye, thereby increasing the IOP.

If the ensuing rise in pressure is sudden, pain, blurred vision, and nausea may occur. Optic nerve damage may also occur due to the increased IOP, either in a sudden attack or in intermittent episodes over a long period of time.

Sometimes, the attack may be caused by dilation of the pupils, possibly during an eye examination. In eyes that are anatomically smaller, pupillary block may occur, causing acute angle closure glaucoma. In pupillary block, a brief episode of obstruction of aqueous fluid can occur by the pupil coming into contact with the structures behind it, usually the lens of the eye. This causes the pressure of the fluid behind the iris (in the posterior chamber) to be higher than the pressure of fluid in front of the iris (in the anterior chamber), causing the iris to be pushed forward, initiating closure of the angle.

Acute angle closure glaucoma may be primary or secondary. In primary acute angle closure glaucoma, there is no underlying eye disease that is causing the condition. Secondary acute angle closure glaucoma occurs because of another eye disease or condition, trauma, drugs, or a chronic medical condition.

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See the Entire Acute Angle-Closure Glaucoma Topic Guide »