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In the figures above, notice the drainage angle, which is the space just above the edge of the iris (brown part of the eye) marked with the arrow. The left figure shows a normal “open” angle, but the right figure shows anatomical closure. The problem occurs when 360 degrees of “plugging” occurs. The pressure quickly rises in the eye (above 21mmHg). This causes achy pain, redness, blurred vision, and swollen hazy cornea (the clear “watch glass” portion). Patients often experience “rainbow colored haloes” around lights. Also, the pupil will usually be mid-dilated and fixed. Many patients experience a headache that surrounds the eye during an attack. Also, people will often suffer from nausea and even vomiting.
Treatment of narrow angle glaucoma or prophylaxis against this event is demonstrated in the figures above. The left figure shows laser energy creating a hole, or ididotomy, to release the fluid trapped behind the iris. It is important to note that the laser iridotomy does not directly lower pressure in the eye. The iridotomy is designed to allow the fluid inside the eye a chance to get to the existing normal drains. If these drains have experienced damage that is too great they may not flow as much as is needed to achieve the desired pressure. In this situation your doctor may recommend medical or even more surgical therapy depending on the situation.