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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.

Patient Education

  • Instruct patients to avoid medicines that cause pupillary dilatation & induce an acute angle-closure crisis (eg decongestants, adrenergic agents, anticholinergics, antipsychotics, antidepressants, motion sickness medications)
  • Teach patients on how to properly instill eye drops (intervals, lid closure, punctal occlusion)
    • Punctal occlusion & eyelid closure for at least 3 minutes
    • If ≥2 drops are to be instilled, wait at least 5 minutes between drops
    • Demonstrate the preferred method & ensure patient can do it
  • Communicate to the patient & family the importance of compliance since glaucoma is a chronic disease which requires continuous patient cooperation for successful management
  • Advise patients w/ family history of PAC to undergo regular eye screening examinations for this condition
  • Inform patients at risk for acute angle-closure about its symptoms & instruct them to notify immediately should these symptoms occur
  • Provide educational materials
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