Question

What are the stages of primary angle closure glaucoma?

Hint:

Acute angle closure is a medical emergency. Prompt intervention is critical to prevent permanent damage to the optic nerve.

Answer 1

Step 1: Stages of Primary Angle Closure Glaucoma.
Primary angle closure glaucoma (PACG) is a condition in which the drainage angle of the eye becomes obstructed, leading to increased intraocular pressure (IOP) and potential damage to the optic nerve. The stages of PACG are:
(1) Stage 1 (Pre-Angle Closure):
- In this stage, the angle of the anterior chamber is narrow, but there is no significant obstruction to aqueous humor outflow. The patient may be asymptomatic or experience intermittent episodes of elevated IOP, often triggered by dilating pupils.
(2) Stage 2 (Acute Angle Closure):
- This is the acute phase where the angle becomes fully obstructed, causing a rapid increase in IOP. It typically presents with symptoms such as severe eye pain, redness, blurred vision, halos around lights, nausea, and vomiting. This is a medical emergency requiring urgent treatment.
(3) Stage 3 (Chronic Angle Closure):
- If the acute phase is untreated or not managed properly, the condition can progress to a chronic phase, where the angle remains closed but the IOP may be moderately elevated or normalized. Optic nerve damage and visual field loss may develop over time.
(4) Stage 4 (End-Stage Glaucom:
- In this stage, there is severe and irreversible optic nerve damage and visual field loss. The patient may have limited or no useful vision, and the condition is often difficult to manage.