Primary Angle-Closure Glaucoma Follow-up

Updated: May 09, 2016
  • Author: Clement Chee-yung Tham, BM, BCh, MA, FRCS(Glasg); Chief Editor: Hampton Roy, Sr, MD  more...
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Follow-up

Deterrence/Prevention

The risk factors for the development of angle-closure glaucoma are listed below. Individuals with such risk factors may consider ophthalmological screening.

  • Female
  • Asian descent
  • Increasing age
  • Hypermetropia
  • Positive family history
  • Cataract

An eye with previous acute primary angle closure (PAC) has over 50% chance of developing primary angle-closure glaucoma (PACG), despite laser peripheral iridotomy. These patients should be regularly monitored. Preventive measures, such as laser peripheral iridoplasty or lens extraction, may be indicated to lower this risk.

The fellow eye in a patient with a previous episode of acute PAC (acute glaucoma) has a 50% chance of developing acute PAC in 5 years and should be screened for narrow angle by gonioscopy. Prophylactic laser peripheral iridotomy is often indicated in the fellow eye to prevent acute or progressive angle closure.

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Complications

Cataract can occur with steroid and laser treatment.

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Prognosis

The prognosis is favorable with control of the IOP. [70]

Factors associated with disease progression in PACG eyes include large IOP fluctuations [71] and a thin central corneal thickness. [72]

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Patient Education

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education articles Glaucoma Overview, Glaucoma FAQs, Glaucoma Medications, and How to Instill Your Eyedrops.

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