Predisposing factors for primary closed angle glaucoma

The following have been implicated as risk factors for the development of the disease:

• sex - female: male ratio 4:1
• race - more in Asians
• short axial length - hypermetropia
• shallow anterior chamber - in females>males
• increasing age - anterior chamber becomes shallower as the lens grows
• small corneal diameter (1)

In predisposed individuals the following systemic drugs may induce angle closure:

• nebulised bronchodilators - ipratropium bromide and/or salbutamol
• selective serotonin re uptake inhibitors
• tricyclic antidepressants
• muscle relaxants (2)

Reference:

• 1. The College of Optometrists 2009. Glaucoma (primary angle closure) (PACG)
• 2. European Glaucoma Society (EGS) 2008. Terminology and guidelines for glaucoma (3rd edition)