closed (narrow)-angle glaucoma (NAG)

Etiology

• narrowed or occluded anterior chamber angle

Epidemiology

• less common than open angle glaucoma

Clinical manifestations

• increased intraocular pressure
• optic nerve degeneration
• visual field loss
• insidious onset
• blurred vision often attributed to needing new glasses

Management

• pharmacologic agents:
  • timolol maleate (Timoptic) 1 drop BID
  • pilocarpine (Pilocar) 1 drop OU 6 times/day
  • acetazolamide (Diamox) 250 mg PO QD-QID
• laser trabeculoplasty
  • useful in the elderly who may be unfit for surgery or anesthesia
  • long term benefits questionable
• surgery

More general terms

• primary glaucoma

More specific terms

• acute angle-closure glaucoma
• aqueous misdirection
• glaucomatous flecks; glaukomflecken