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Glaucoma Physician

Article

Management of the Primary Angle-closure Suspect

Observation, laser peripheral iridotomy, or cataract surgery can all be viable options.

Ameay V. Naravane, MDJames C. Liu, MD
Glaucoma Physician March 1, 2025 Vol 29, Issue March 2025 Page(s): 5-8

Clinical Scorecard: Management of the Primary Angle-closure Suspect

At a Glance

CategoryDetail
Condition
Key MechanismsRisk of conversion to Primary Angle-closure Glaucoma (PACG) and associated complications, including potential visual impairment and blindness.
Target Population
Care Setting

Key Highlights

  • AS-OCT

Guideline-Based Recommendations

Diagnosis

    Management

    • Prophylactic LPI is recommended for high-risk PACS patients, defined as those with significant narrowing or elevated IOP.
    • Observation may be appropriate for stable PACS without progression.

    Monitoring & Follow-up

      Risks

        Patient & Prescribing Data

        LPI may be preferred over observation in patients with significant narrowing, high IOP, or other risk factors.

        Clinical Best Practices

        • Perform thorough gonioscopy to avoid misclassification of angle-closure patients.
        • Educate patients on signs and symptoms of angle-closure attacks and the risks of untreated PACS.
        • Screen for medications that may increase the risk of acute angle-closure events.

        References