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Glaucoma, Primary Closed-Angle

Richard W Allinson, M.D. and Alyce D Alven, MS, OD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Glaucoma is a progressive decline in vision from damage to the optic nerve, and is usually associated with elevated intraocular pressure (IOP) in the eye. Angle-closure is a mechanic...

DIAGNOSIS

HISTORY

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

  • 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 other eye of patients with APAC will develop APAC within 5 years. Hence, prophylactic LPI should be performed in the other eye as so...

REFERENCES

1
Lin Y-H, Wu C-H, Huang S-M, et al. Early versus delayed phacoemulsification and intraocular lens implantation for acute primary angle-closure. J Ophthalmol. 2020; 2020:8319570. 
2
Tanner L, ...

ADDITIONAL READING

SEE ALSO

Radhakrishnan S, Chen PP, Junk Ak, et al. Laser peripheral iridotomy in primary angle closure: A report by the American Academy of Ophthalmology.  ...

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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