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Glaucoma, Primary Closed-Angle

Salman S. Dar, MD, Sunil Shashikumar Bellur, MD and David A. Belyea, MD, MBA, FACS Reviewed 06/2019
 


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/obj...

TREATMENT

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

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 f...

REFERENCES

1
American Academy of Ophthalmology. Primary Angle Closure Preferred Practice Pattern. San Francisco, CA: American Academy of Ophthalmology; 2016. http://www.aao.org. Accessed July 14, 2018....

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. Op...

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, frontal headache, nausea and vomiting) and asymmetric pupillary response, o...

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