Acute primary angle-closure occurs abruptly, usually accompanied by symptoms such as an IOP spike, nausea, vomiting, blurred vision, halos and headache. Blindness may ensue in nearly 13% of these patients, a new study suggests.

Generally, those of Inuit and Asian ethnicity, as well as women, are at greater risk for developing acute primary angle-closure glaucoma. In China, a multicenter retrospective study was conducted to identify risk factors associated with blindness after treatment of acute primary angle-closure and to identify the critical time window for decreasing the rate of blindness.

The study included 1,030 consecutive subjects (1,164 eyes) with acute primary angle-closure in China. The researchers analyzed the rate of blindness up to three months after treatment and collected information on risk factors such as age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment and presenting IOP.

They found that the rate of blindness after treatment was 12.54% in the population sample. Education level, time from symptom to treatment and presenting IOP were significant risk factors for blindness. The researchers determined that the critical time window associated with a blindness rate of less than or equal to 1% was a mere 4.6 hours. “Timely medical treatment is key in reducing blindness after acute primary angle-closure,” they said.

Li S, Tang G, Fan SJ, et al. Blindness short after treatment of acute primary angle closure in China. Br J Ophthalmol. August 7, 2020. [Epub ahead of print].