primary%20angle-closure%20glaucoma
PRIMARY ANGLE-CLOSURE GLAUCOMA
Primary angle-closure is the synechial or appositional closure of the anterior chamber angle secondary to multiple mechanisms resulting in raised intraocular pressure and structural changes in the eyes.
Iridotrabecular contact is the hallmark of primary angle-closure  and the most commonly identified sign which indicates that treatment is required.
It is defined by at least 180 degrees of iridotrabecular contact together with an elevated intraocular pressure or peripheral anterior synechiae or btoh
Primary angle-closure glaucoma is the presence of glaucomatous optic neuropathy.

Follow Up

  • Following iridotomy, patients w/ a residual open angle or a combination of open angle & some peripheral anterior synechiae (PAS) w/ or w/o glaucomatous optic neuropathy should be followed at least yearly
    • Repeat gonioscopy to determine interval changes (eg increased extent of PAS, development of secondary angle-closure from cataract progression & increased lens thickness) 
  • Subsequent follow-up intervals will depend on the clinical findings
  • Reassess visual function, risk factors [especially gonioscopic changes & intraocular pressure (IOP)], quality of life
  • Reassess structure & function of the optic nerve
  • Assess adherence to the treatment plan
  • Revise management plan, if necessary, & discuss follow-up plan
  • Indications for more frequent surveillance/follow-up:
    • Change in health status
    • IOP above target
    • Side effect to glaucoma medication
    • Disc change
    • Visual field change
    • Intervening eye infection (especially for post-operative eyes), surgery, trauma, iritis
Editor's Recommendations
Most Read Articles
4 days ago
Combining the DASH (Dietary Approaches to Stop Hypertension) diet with low sodium intake reduces systolic blood pressure (SBP) in individuals with pre- and stage 1 hypertension, with progressively higher reductions at greater levels of baseline SBP, a recent study has shown.
Tristan Manalac, 2 days ago
Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
3 days ago
Tadalafil may not be effective for reducing the decline in ambulatory ability in boys with Duchenne muscular dystrophy (DMD), as shown in a recent study.
6 days ago
Hydrochlorothiazide (HCTZ) appears to significantly increase the risks of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinoma (SCC), a recent study has shown.