Ailment Is 'Very, Very Painful'

Acute glaucoma, the eye disease that required Governor Paterson to undergo emergency surgery yesterday, is a rare but exceedingly painful condition that can progress to an acute stage within minutes or hours, doctors said.

Mr. Paterson, who is legally blind, was diagnosed yesterday with acute angle-closure glaucoma in his left eye. He was treated at Mount Sinai Medical Center, where he initially sought treatment for a bad headache early in the morning.

Glaucoma is caused by a buildup of fluid in the eye. If left untreated, it can damage the optic nerve and cause blindness.

"It's very, very painful," an ophthalmologist at NYU Langone Medical Center who was not involved in Mr. Paterson's care, Dr. Robert Cykiert, said. "Imagine blowing up a balloon with too much air. That's kind of what this is about." Mr. Paterson underwent a laser iridotomy, a widely used treatment in which doctors create a tiny hole in the patient's iris in order to drain excess fluid from the eye. The procedure, which takes about five minutes, is considered safe and highly effective. Because patients with glaucoma in one eye typically develop the condition in the other, doctors usually recommend a preventive iridotomy for the second eye.

According to the surgeon who operated on Mr. Paterson, Dr.

John Danias, the governor will undergo an iridotomy on his right eye in the next few days. Dr. Danias said Mr. Paterson's glaucoma was not related to his visual impairment.

Mr. Paterson lost sight in his left eye and much of his right eye as a child as a result of an infection. Dr.

Danias said other than the glaucoma, Mr. Paterson appeared to be in good health, although he was "tired from going through this experience."

Patients with glaucoma typically have an anatomical predisposition to the condition, such as a narrow passageway in the front portion of their eye where fluid drains.

Acute glaucoma can occur when a person's pupil dilates, either because of low light, stress, or certain medications such as antihistamines.

About 3 million Americans have glaucoma, with 10% experiencing acute glaucoma. Glaucoma is the second-leading cause of blindness worldwide, and it is six to eight times more common among blacks than whites, according to the Glaucoma Research Foundation.