Treatment of Chronic Angle-Closure Glaucoma with Occluded Anterior Chamber Angle, Symptomatic High IOP, and Headache

This protocol addresses the specific presentation of chronic angle-closure glaucoma in which the anterior chamber angle is occluded and intraocular pressure is markedly and symptomatically elevated — consistent with an acute angle-closure crisis (AACC).

Clinical scenario

        Patients present with prominent headache, eye pain, nausea and vomiting, and blurred vision with halos. Examination reveals markedly elevated intraocular pressure, corneal edema, conjunctival and episcleral vascular congestion, and a mid-dilated pupil.

Treatment direction

For AACC unresponsive to conventional treatment, management involves surgical intervention — including lens-based procedures, with adjunctive options available in selected cases. The complete protocol specifies the full selection criteria and sequencing.

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References

DOI: 10.1016/j.ophtha.2025.12.030

Acute angle-closure crisis (AACC): occluded angle with symptomatic high IOP

Symptoms of AACC include eye pain, headache, nausea/vomiting, and blurred vision with halos.

Clinical signs of AACC are markedly elevated IOP, corneal edema, conjunctival and episcleral vascular congestion, and/or a mid-dilated pupil.

Other treatments for AACC unresponsive to conventional treatment include phacoemulsification, phacoemulsification combined with other glaucoma procedures, and cyclophotocoagulation.

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