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.
Following iridotomy, patients with a residual open angle or a combination of open angle and some peripheral anterior synechiae (PAS) with or without 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 and increased lens thickness)
Subsequent follow-up intervals will depend on the clinical findings
Reassess visual function, risk factors [especially gonioscopic changes and intraocular pressure (IOP)], quality of life
Reassess structure and function of the optic nerve
Assess adherence to the treatment plan
Revise management plan, if necessary, and discuss follow-up plan
Indications for more frequent surveillance/follow-up:
Change in health status
IOP above target
Side effect to glaucoma medication
Visual field change
Intervening eye infection (especially for post-operative eyes), surgery, trauma, iritis
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa,
08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Spending too much time sitting cannot be good for the body, and rising to one's feet breaks up such a behaviour and yields small, but meaningful, reductions in certain cardiovascular disease (CVD) risk factors, according to the results of a meta-analysis.