Tuesday, December 12, 2006

Section 9-E: Prevention and 9-F: References

Before any attacks occur (prevention for both eyes). Critically narrow drainage angles may be recognized prior to an attack of acute angle closure. Such drainage angles may be identified by an eye doctor by gonioscopy (Chapter 6-C). When detected, critically narrow drainage angles need treatment with a laser peripheral iridotomy (see above) to prevent attacks of acute angle closure glaucoma. In most cases laser peripheral iridotomy is performed in one eye at a time, within a few weeks of each other.

After an attack (prevention in the other eye). When a patient has an attack of acute angle closure glaucoma in one eye, it is treated emergently. In many cases, the fellow eye also has a critically narrow drainage angle and is at high risk for acute angle closure as well. A laser peripheral iridotomy should be performed to prevent acute angle closure in the fellow eye as soon as the eye with acute angle closure becomes stable after treatment.

Section 9-F: References.

Allingham RR, et al., editors. Shields’ Textbook of Glaucoma, ed. 5. Philadelphia: Lippincott Williams & Wilkins, 2005. pp. 217-234.

Alward WLM. Glaucoma. St. Louis: Mosby, 2000. pp. 141-154.

Simmons RB, Montenegro MH, Simmons RJ. “Primary angle-closure glaucoma”. In Tasman W ed. Duane’s Clinical Ophthalmology, Lippincott Williams & Wilkins, 2005. Chapter 53.


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