Primary Angle-Closure Glaucoma Disease Summary

Overview

Primary angle-closure glaucoma is a synechial or appositional closure of the anterior chamber angle secondary to multiple mechanisms resulting in raised intraocular pressure (IOP) and structural changes in the eyes but without glaucomatous optic neuropathy, as stated in the Introduction section.

Glaucoma is the leading cause of irreversible visual impairment and blindness worldwide, with primary angle-closure glaucoma being three times more common in Asian population compared to European population. A detailed discussion about the prevalence of primary angle-closure glaucoma is in the Epidemiology section.

The Pathophysiology section states that the mechanisms responsible for angle closure are defined in terms of the anatomic location of obstruction to aqueous flow. Pupillary block mechanisms and obstructions at the level of the iris and/or ciliary body are discussed in detail in this section.

The demographic and ocular risk factors for primary angle-closure disease are enumerated in Risk Factors section. Different classifications of primary angle-closure disease spectrum are explained in the Classification section.

Primary Angle-Closure Glaucoma_Disease Summary

History and Physical Examination

The History section describes the importance of obtaining the past ophthalmic history, past medical history, family history and socioeconomic factors in the assessment of primary angle-closure glaucoma.

The Physical Examination section discusses the different methods used for a thorough ophthalmological examination in the evaluation of primary angle-closure glaucoma.

Diagnosis

The Diagnosis or Diagnostic Criteria section features the clinical subtypes and diagnostic criteria in the evaluation of primary angle-closure glaucoma. Proper screening of patients with glaucoma is discussed in Screening section.

Discussions about ocular biometry and provocative testing are in the Laboratory Tests and Ancillaries section.  Anterior segment imaging is explained in the Imaging section.

Other diseases that can present with the same symptoms as primary angle-closure glaucoma are listed in the Differential Diagnosis section.

Management

The goals of treatment and setting of IOP target are discussed in the Principles of Therapy section.

The Pharmacological Therapy section discusses in detail the medical therapy, both pre- and postoperative therapy, and adjunctive medical therapy in the management of primary angle-closure glaucoma.

The Nonpharmacological Therapy section includes things to educate the patient such as the proper administration of medication, the medicines to avoid and the importance of compliance for a successful management of primary angle-closure disease.

Several interventions and treatment options for the management of primary angle-closure glaucoma are in the Surgery section.

The Monitoring section identifies the frequency of follow-up and surveillance in patients with primary angle-closure glaucoma depending on their clinical findings, risk factors and adherence to treatment plans.