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Evidence-based Clinical Practice Guidelines for the Management of Glaucoma in the Adult Eye
Angle-closure Glaucomas
Angle-closure glaucomas
The most useful classification for angle-closure glaucoma is based upon etiology. The most important criterion is the presence or absence of pupil block, with further subclassification into primary and secondary mechanisms. The prevalence of PACG varies significantly among different ethnic groups.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Angle-closure glaucomas
Patients with PACG commonly present with 1 of 3 possible scenarios:
acute angle closure, narrow angle at risk of acute closure with normal IOP, or creeping angle closure with or without elevated IOP.
Patients may present with what appears to be chronic OAG, but angle closure is subsequently discovered on gonioscopy.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Non-pupil block
Ciliary block Lens-induced Anterior mechanism Angle neovascularization Iritis ICE syndrome Epithelial down growth
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Signs include:
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
family history of acute glaucoma or previous laser iridotomy in a first-degree relative, and personal history indicative of symptoms of previous intermittent attacks of angle closure.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
When the trabecular meshwork can be visualized for 360, but the approach is very narrow and therefore felt to be at risk for closure, consideration should also be given to performing an iridotomy.
1. Ang LP, et al. Ophthalmology 2000;107:20926. 2. Friedman DS, et al. Ophthalmology 2006;113:108791.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
1. Ang LP, et al. Ophthalmology 2000;107:20926. 2. Friedman DS, et al. Ophthalmology 2006;113:108791.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Neovascular Glaucoma
Neovascular glaucoma
Neovascular glaucoma is a common form of secondary non-pupil block anterior-mechanism glaucoma. The most common inciting factors are: posterior segment ischemia due to central retinal vein occlusion, or diabetes mellitus. These lead to anterior segment iris and angle new vessel formation. The angle new vessels form a fibrovascular membrane, which contracts to create PAS and angle closure.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.
Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009;44(Suppl 1):S1S93.