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

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...

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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