Small eye size alone does not predict primary angle closure glaucoma

Harry A. Quigley

PHILADELPHIA — Choroidal expansion, vitreous collapse and other risk factors play roles in primary angle closure glaucoma, a speaker said here.

"Angle closure results from eyes that start out with smaller eye size, but the anatomy of that alone is not the answer," Harry A. Quigley, MD, said during the Arthur J. Bedell Lecture at the Wills Eye Institute Alumni Conference.

Prevailing opinion has held that "creeping angle closure" and iridotomy in patients with narrow angles lead to the development of glaucoma, he said.

"It has been said that a large number of persons who have narrow angles and primary angle closure who have iridotomy will go on to develop creeping angle closure," Dr. Quigley said. "Their angles will keep right on closing despite having the iridotomy, and this is quite commonly published in the literature, especially in Asia."

However, recent studies on patients who had acute attacks in the fellow eye showed only a small number of those patients developing creeping angle closure.

"It doesn't happen very often," Dr. Quigley said. "So if you do an iridotomy, many of the patients are going to have their problem cured if it's done before there's permanent angle damage."