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Glaucoma, Primary Closed-Angle

Richard W. Allinson, MD and Francis Allinson, MD Reviewed 06/2020
 


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. Angle-closure is...

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/obj...

TREATMENT

ALERT

For patients with acute symptoms (severe eye pain, blurred vision, eye redness, halos around lights/objects, headache, nausea and vomiting) and asymmetric pupillary response, obtain imm...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Half of the patients with AACC will develop AACC in the other eye within 5 years. Hence, prophylactic LPI should be performed in the other eye a...

REFERENCES

1
Johnson TV, Ramulu PY, Quigley HA, et al. Low sensitivity of the Van Herick method for detecting gonioscopic angle closure independent of observer expertise. Am J Ophthalmol.  2018;19...

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

CLINICAL PEARLS

For patients with acute symptoms (severe eye pain, blurred vision, eye redness, halos around lights/objects, headache, nausea and vomiting) and asymmetric pupillary response, obtain im...

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