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Glaucoma, Primary Closed-Angle

Sunil Bellur, MD, Salman Dar, MD and David Belyea, MD, MBA, FACS Reviewed 06/2018
 


BASICS

DESCRIPTION

Glaucoma is a progressive decline in vision that is usually associated with elevated intraocular pressure (IOP) in the eye, which leads to damage of the optic nerve. Primary angle cl...

DIAGNOSIS

HISTORY

  • Patient may be asymptomatic as in PACS or may have acute symptoms as in AACC.

  • Acute symptoms commonly include unilateral:

    • Severe eye pain

    • Blurred vision

    • Eye redness

    • Halos around lights/o...

TREATMENT

GENERAL MEASURES

  • Goals of treatment (1)[C]:

    • Reverse or prevent angle-closure process.

    • Control IOP.

    • Prevent damage to the optic nerve.

  • PACS

    • Majority will not develop PAC or PACG.

    • May be either o...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Schedule immediate ophthalmology follow-up. 

Patient Monitoring

  • Postsurgical follow-up and routine monitoring after acute attack as per ophthalmologist.

  • Half of the ...

REFERENCES

1
American Academy of Ophthalmology. Primary Angle Closure Preferred Practice Pattern. San Francisco, CA: American Academy of Ophthalmology; 2015. http://www.aao.org. Accessed December 6, 20...

ADDITIONAL READING

  • Gupta D, Chen PP. Glaucoma. Am Fam Physician.  2016;93(8):668–674. [View Abstract on OvidMedline]

  • Kolko M. Present and new treatment strategies in the management of glaucoma. O...

SEE ALSO

Glaucoma, Primary Open-Angle 

CODES

ICD10

  • H40.20X0 Unsp primary angle-closure glaucoma, stage unspecified

  • H40.219 Acute angle-closure glaucoma, unspecified eye

  • H40.2290 Chronic angle-closure glaucoma, unsp eye, stage unspecified

  • H40.2...

CLINICAL PEARLS

  • Examiner can determine if patient is hyperopic by observing the magnification of the patient’s face through his or her glasses (myopic lenses minify).

  • A careful history may reveal simil...

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