Angle-closure glaucoma

Prophylactic treatment for the fellow eye is recommended.[1]American Academy of Ophthalmology. Preferred practice pattern: primary angle closure. Nov 2020 [internet publication]. https://www.aao.org/preferred-practice-pattern/primary-angle-closure-disease-ppp ​ The most common prophylactic treatment is a laser peripheral iridotomy.[1]American Academy of Ophthalmology. Preferred practice pattern: primary angle closure. Nov 2020 [internet publication]. https://www.aao.org/preferred-practice-pattern/primary-angle-closure-disease-ppp

The fellow eye of a patient with acute angle-closure should be evaluated because it is at high risk for a similar event.[1]American Academy of Ophthalmology. Preferred practice pattern: primary angle closure. Nov 2020 [internet publication]. https://www.aao.org/preferred-practice-pattern/primary-angle-closure-disease-ppp ​ The risk is significantly reduced if an iridotomy or iridectomy is performed in the fellow eye.[1]American Academy of Ophthalmology. Preferred practice pattern: primary angle closure. Nov 2020 [internet publication]. https://www.aao.org/preferred-practice-pattern/primary-angle-closure-disease-ppp [66]Ang LP, Aung T, Chew PT. Acute primary angle closure in an Asian population: long-term outcome of the fellow eye after prophylactic laser peripheral iridotomy. Ophthalmology. 2000 Nov;107(11):2092-6. http://www.ncbi.nlm.nih.gov/pubmed/11054339?tool=bestpractice.com

Vision rehabilitation should be individualised to each patient and extend beyond medical therapies to improve other meaningful outcomes (e.g., reading, daily living activities, safety, community participation, and psychosocial well-being).[67]Jackson ML, Virgili G, Shepherd JD, et al. Vision rehabilitation preferred practice pattern®. Ophthalmology. 2023 Mar;130(3):P271-335. hhttps://www.aaojournal.org/article/S0161-6420(22)00869-7/fulltext Consider referral to consultant rehabilitation services where these are available.​​