Profile of presenting states of eyes in angle-closure glaucoma

Abstract

A survey was made of 77 patients with closed-angle glaucoma who presented to the Professorial Unit of the Manchester Royal Eye Hospital between January, I966, arid July, I969. Females (75-3 per cent.) outnumbered males (24.7 per cent). Only 39 (50.6 per cent.) had acute closed-angle glaucoma in the presenting eye; of these eight were males and 31 females (difference significant at P 21 mm. Hg) and closed angles in both eyes. Pathological cupping of the optic discs was seen in 2I presenting and 9 fellow eyes. In presenting eyes, central retinal vein occlusion was found in one, thrombotic glaucoma in one, and absolute closed-angle glaucoma in three. The fellow eye in these five patients was found on gonioscopy to be predisposed to angle closure in four cases, while chronic closed-angle glaucoma was present in the fifth. Of 39 patients with acute closed-angle glaucoma in the presenting eye, one had central retinal vein occlusion associated with thrombotic glaucoma, and two had absolute closed-angle glaucoma in the fellow eye; these three patients had apparently ignored the symptoms in the "fellow" eyes. Careful assessment of both eyes (N.B. the fellow as well as the presenting eye) by tonometry and gonioscopy must therefore be done in all cases ofglaucoma or suspected glaucoma even when the ocular tension is normal, and in all cases of central (and tributary) retinal vein occlusion and thrombotic glaucoma. A careful differentiation between thrombotic glaucoma and chronic closed-angle glaucoma is important. Absolute glaucoma should be subdivided into open-angle and closed-angle types.