Narrow or Occludable Angle

Narrow or occludable angle (primary angle closure suspect: PACS) is the abnormality of the positioning of iris that close the angle. In the eye there is a circulation of the fluid called aqueous humor. The aqueous humor is produced by the ciliary body. When aqueous humor is produced it is first released into the posterior chamber before flowing through a cleft between the iris and lens and then flow into the anterior chamber. After that the aqueous humor will drain out via a small drainage system at the angle of the eye called trabecular meshwork and be absorbed into the veins. The narrow or occludable angle is when the angle of the eye is narrow or closed by the iris. It can run in the family and is frequently found in some ethnic groups such as Asian.

If it is not acute, usually there is no symptom shown until it is found during eye exam by the ophthalmologist.
  • 40 years and above.
  • Family history.
  • It is 3 times more frequently in female than male.
  • Long sightedness that is not age-related.
  • It is more found in Asian and Eskimo.
Those with narrow angle or partially closed angle are likely to develop acute angle closure glaucoma. This happens when the eye pressure is suddenly rising up very high, causing acute and severe pain, red eye, blurred vision, seeing halo around the light, nausea and vomit. In some cases of closed angle presented with chronic angle closure glaucoma, which is when the eye pressure is gradually elevated and optic nerve is damaged without any symptoms during early stage.
The ophthalmologist will exam anterior chamber, the appearance of the angle (the drainage area between the cornea and iris) throughout 360 degrees using a special lens which will be gently placed on the cornea and it is not a harmful procedure. Other devices might be used for diagnosis and consideration of the treatment plan.

If the angle is narrow or closed more than 180 degrees, although without any symptoms shown, patients should be treated by laser peripheral iridotomy to reduce the risk of primary angle closure glaucoma.
Visit the ophthalmologist to assess primary angle closure glaucoma.

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