• 1 Department of Ophthalmology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK
  • 2 The NIHR Biomedical Research Centre, Moorfields Eye Hospital, NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK
  • 3 Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland, UK
  • 4 Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, Scotland, UK
  • 5 Ophthalmology, Ninewells Hospital, Dundee, Scotland, UK
  • 6 Ophthalmology, Raigmore Hospital, Inverness, Scotland, UK
  • 7 Department of Ophthalmology, University Malaysia, Kota Samarahan, Sarawak, Malaysia
  • 8 British Ophthalmic Surveillance Unit, The Royal College of Ophthalmologists, London, UK
  • 9 Centre for Vision and Vascular Science, Queen's University, Belfast, Northern Ireland, UK
Br J Ophthalmol, 2018 Apr;102(4):539-543.
PMID: 28794074 DOI: 10.1136/bjophthalmol-2017-310725


PURPOSE: To estimate the incidence, and describe the clinical features and short-term clinical outcomes of acute angle closure (AAC).

METHODS: Patients with newly diagnosed AAC were identified prospectively over a 12-month period (November 2011 to October 2012) by active surveillance through the Scottish Ophthalmic Surveillance Unit reporting system. Data were collected at case identification and at 6 months follow-up.

RESULTS: There were 114 cases (108 patients) reported, giving an annual incidence of 2.2 cases (95% CI 1.8 to 2.6) or 2 patients (95% CI 1.7 to 2.4) per 1 00 000 in the whole population in Scotland. Precipitating factors were identified in 40% of cases. Almost one in five cases was associated with topical dilating drops. Best-corrected visual acuity (BCVA) at presentation ranged from 6/6 to perception of light. The mean presenting intraocular pressure (IOP) was 52 mm Hg (SD 11). Almost 30% cases had a delayed presentation of 3 or more days. At 6 months follow-up, 75% had BCVA of 6/12 or better and 30% were found to have glaucoma at follow-up. Delayed presentation (≥3 days) was associated with higher rate of glaucoma at follow-up (22.6% vs 60.8%, p<0.001), worse VA (0.34 vs 0.74 LogMAR, p<0.0001) and need for more topical medication (0.52 vs 1.2, p=0.003) to control IOP.

CONCLUSION: The incidence of AAC in Scotland is relatively low compared with the Far East countries, but in line with previous European data. Almost one in five cases were associated with pupil dilation for retinal examination.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.