How Is Narrow-Angle Glaucoma Treated?

Receiving a diagnosis of narrow-angle glaucoma can raise a lot of questions. This type of glaucoma, also called closed-angle or angle-closure glaucoma, affects the drainage system inside the eye and can lead to dangerously high eye pressure.

Fortunately, a straightforward laser procedure can often prevent or treat the condition before significant damage occurs. Keep reading to learn what narrow-angle glaucoma treatment involves and whether it may be right for you.

What Is Narrow-Angle Glaucoma?

Inside the eye, fluid is constantly produced and drained through a structure called the drainage angle. In some eyes, the anatomy is naturally narrow, meaning the iris sits close to the drainage angle and can block fluid from flowing out properly. When fluid becomes trapped, eye pressure rises, and over time, that pressure can damage the optic nerve and threaten vision.

An eye doctor can evaluate the drainage angle using a procedure called gonioscopy, which uses a special contact lens to directly examine the angle structure. This exam helps identify which patients are at risk and who may benefit from early treatment, even before glaucoma has fully developed.

How Laser Iridotomy Treats Narrow-Angle Glaucoma

The most common treatment for narrow-angle glaucoma is a laser iridotomy. During this procedure, a laser creates a small opening in the iris, allowing fluid trapped behind it to flow more freely. This relieves the pressure pushing the iris forward and helps keep the drainage angle open.

Laser iridotomy is used both as a treatment for eyes that already have narrow-angle glaucoma and as a preventive measure for eyes at high risk. It is generally recommended when the drainage angle is closed for at least half the eye and eye pressure is elevated or optic nerve damage is present.

In eyes with narrow angles, normal pressure, and no nerve damage, the procedure may still be recommended to reduce the risk of a future pressure spike.

What to Expect During and After the Procedure

Before and During the Procedure

About 30 minutes before the laser, eye drops are administered to dilate the pupil, preparing the eye for treatment. Anesthetic drops are then placed to numb the surface, and a lens is positioned on the eye to guide the laser. The procedure typically takes 5 to 10 minutes.

After the Procedure

Vision may be temporarily blurry immediately after the procedure, and the eye can feel red, light-sensitive, or mildly uncomfortable for a short time. A mild headache from the pre-treatment drops is also possible. 

Eye pressure is checked within 30 minutes to two hours following the laser, and anti-inflammatory drops are usually prescribed for a few days to reduce inflammation. One thing to keep in mind: laser iridotomy is designed to preserve your vision and prevent glaucoma from progressing, not to improve vision you may have already lost.

Risks and Realistic Expectations

Like any procedure, laser iridotomy carries some risks, though most are temporary. A short-term rise in eye pressure, minor bleeding at the treatment site, and mild inflammation can occur but typically resolve on their own. In rare cases, patients may notice extra visual images, flashes of light, or double vision in the treated eye. Occasionally, the opening created by the laser may close over time, requiring a repeat treatment.

Your eye doctor will review these risks with you and help determine whether the benefits of treatment outweigh the potential downsides for your specific situation.

Take the Next Step to Protect Your Vision

Narrow-angle glaucoma is a serious condition, but it is also one that can often be addressed before lasting damage occurs. Laser iridotomy is a well-established procedure that provides patients with a meaningful way to protect their vision in the long term. 

To find out whether you may be a candidate, schedule a consultation at Mid Ohio Eye in Columbus, OH, today.

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