Angle-closure glaucoma

After the resolution of an episode of acute angle-closure glaucoma, eyes should be assessed for degree of angle closure, the presence of peripheral anterior synechiae (PAS), degree of cataract, and optic disk and visual field damage. Intraocular pressure (IOP) should be checked multiple times to detect asymptomatic rise in IOP. The second eye should be assessed and treated to prevent attack.[5]Hollows FC, Graham PA. Intra-ocular pressure, glaucoma, and glaucoma suspects in a defined population. Br J Ophthalmol. 1966 Oct;50(10):570-86. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC506274/pdf/brjopthal00370-0011.pdf http://www.ncbi.nlm.nih.gov/pubmed/5954089?tool=bestpractice.com ​​[35]American Academy of Ophthalmology. ​Glaucoma summary benchmarks - 2023. Dec 2023 [internet publication]. https://www.aao.org/education/summary-benchmark-detail/glaucoma-summary-benchmarks-2020 ​​

After the acute episode of angle closure has been addressed, patients with a residual open angle or a combination of open angle and PAS should be followed at appropriate intervals to check for increasing PAS. Repeat gonioscopy should be performed to evaluate extent of PAS and to check for development of secondary angle closure. Timing of subsequent follow up is dependent on clinical findings and the judgment of the treating ophthalmologist.[17]American Academy of Ophthalmology. Preferred practice pattern: primary angle closure. November 2020 [internet publication]. https://www.aao.org/preferred-practice-pattern/primary-angle-closure-disease-ppp