Acute Angle-Closure Glaucoma in Emergency Medicine Follow-up

Updated: Nov 19, 2018
  • Author: Joseph Freedman, MD; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Follow-up

Further Outpatient Care

Patients remain on oral acetazolamide, pilocarpine, and beta-blockers or alpha-agonists until definitive treatment. After laser peripheral iridotomy (LPI), 33% of patients require topical medication to maintain lower intraocular pressure (IOP).

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Further Inpatient Care

A low threshold for admission should be used with acute angle-closure glaucoma (AACG) patients. Immediate ophthalmologic consultation must be arranged and admission may be required based on their treatment protocol and the patient's response to therapy. Patients who received osmotic agents may require electrolyte and volume status monitoring, particularly those with co-morbid illnesses.

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Deterrence/Prevention

Fellow eye surgery

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Complications

Complications may include the following:

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Prognosis

Several studies evaluated patients after treatment for AACG and demonstrated favorable outcomes. With adequate treatment, most patients recover their lost vision. In whites, IOP was controlled with LPI alone in 65-76%. Asians more often have medically refractory initial attacks and require medications after LPI. [5] They also have higher rates of vision loss and subsequent increases in IOP. [5] It has been hypothesized that the initial attack is often more severe in Asians resulting in greater trabecular damage. Another possibility is the formation of peripheral synechiae (adhesions) causing a creeping angle reclosure.

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Patient Education

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