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-Blanco A, Munoz B, Friedman DS, Foster PJ. The prevalence of primary angleclosureglaucoma in European derived populations: a systematic review. Br J Ophthalmol. 2012;96(9):1162-7 Hui X, Michelessi M. Medical interventions for treating primary angle-closureglaucoma. Cochrane Database of Systematic Reviews 2015;12:CD012001 Lachkar Y, Bouassida W. Drug-induced acuteangleclosureglaucoma Curr Opin Ophthalmol 2007;18:129-33 Napier ML, Azuara-Blanco A. Changing patterns in treatment of angleclosure (...) glaucoma. Curr Opin Ophthalmol. 2018;29(2):130-4 Rich R. The pilocarpine paradox. Journal of Glaucoma. 1996;5:225-7 Lay summary Primary AngleClosureGlaucoma (PACG) is rarer in this country than Primary Open AngleGlaucoma, and in its acute form differs in that the drainage route for the fluid inside the eye is closed off, rather than gradually blocked. It affects women more often than men, is commoner in long-sighted people and people of East Asian ancestry, and becomes more likely to occur as people
Angle-closureglaucomaAngle-closureglaucoma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Angle-closureglaucoma Last reviewed: February 2019 Last updated: March 2018 Summary Acuteangle-closureglaucoma is an urgent but uncommon, dramatic symptomatic event with blurring of vision, painful red eye, headache, nausea, and vomiting. Diagnosis is made by noting high intra-ocular pressure, corneal oedema, shallow (...) -closureglaucoma (ACG) is a group of diseases in which there is reversible (appositional) or adhesional (synechial) closure of the anterior-chamber angle resulting in elevation of the intra-ocular pressure (IOP). The angleclosure may occur in an acute or chronic form. In the acute form, the IOP rises rapidly as a result of relatively sudden blockage of the trabecular meshwork by the iris, via the pupillary block mechanism (mechanism that pushes iris from behind leading to angleclosure). The chronic
Medical Concepts: AcuteAngleClosureGlaucomaAcuteAngleClosureGlaucoma Review - CanadiEM Medical Concepts: AcuteAngleClosureGlaucoma In by Stephanie Cargnelli October 11, 2016 A 62 year old woman presents to your Emergency Department with a chief complaint of severe right eye pain. Upon further questioning, she reveals reduced vision in the affected eye and colored halos around lights. She reports a diffuse headache and two episodes of vomiting. A quick physical exam reveals significant (...) conjunctival injection and a fixed, mid-dilated pupil. Does your differential contain acuteangleclosureglaucoma? What is AcuteAngleClosureGlaucoma? Acuteangleclosureglaucoma is a condition characterized by raised intraocular pressure due to impaired outflow of aqueous humor from the posterior chamber of the eye. 1 In a normal eye, the aqueous humor is produced in the posterior chamber by the ciliary process and proceeds to flow through the pupil to the anterior chamber and out through
Acuteangleclosureglaucoma â€“ A potential blind spot in critical care We report a case of a 69-year-old gentleman who developed an acutely painful eye with loss of visual acuity whilst on the critical care unit. He was admitted three days previously with an infective exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation. In addition, he received intravenous antibiotics, steroids, nebulised bronchodilators and intravenous aminophylline, together (...) with noradrenaline for blood pressure support. On development of visual symptoms, an emergency ophthalmology review diagnosed acuteangleclosureglaucoma. Treatment with pilocarpine eye drops, intravenous acetazolamide and bilateral YAG laser iridotomies provided immediate symptom relief and he went on to make an excellent recovery. Acuteangleclosureglaucoma is a potentially devastating ophthalmic emergency. Critical care patients are at particular risk for the development of this condition due to the use
An unusual case of acuteangle-closureglaucoma following deep anterior lamellar keratoplasty using the â€œbig bubbleâ€ technique To report the first case of acuteangleclosure due to a high-pressure Descemet membrane detachment following deep anterior lamellar keratoplasty (DALK) using the "big bubble" technique.A 25-year-old man underwent DALK surgery for keratoconus using the "big bubble" technique in which an air bubble is injected in deep stroma to promote dissection of underlying (...) Descemet membrane from stroma. Surgery was uneventful and the patient was discharged home in good conditions. On post-operative day 1, the patient came back with severe periocular pain. Intra-ocular pressure was found to be 38 mmHg. Anterior-segment OCT revealed a "double anterior chamber" created by a high-pressure Descemet detachment that was occluding the pupil and causing secondary acuteangleclosureglaucoma. The patient was brought back promptly to the operating room where the high-pressure
with a diagnosis of low grade ciliary body melanoma. This patient experienced eventual mechanical angleclosure with a CWS appearing in the posterior pole in the setting of acute elevation of intraocular pressure (IOP). This eye underwent enucleation and pathology evaluation.Fundus photography documented a CWS in the posterior segment during a period of acute elevation in IOP. Subsequently the eye was enucleated due to pain from refractory angleclosureglaucoma secondary to low grade iris-ciliary body ring (...) in the setting of acute elevations of IOP and may be associated with loss of nerve fiber layer. This loss of nerve fiber layer can confound the ability to judge glaucoma progression based on nerve fiber layer thickness via optical coherence tomography and changes in disc contours. Patient care may benefit from care provider's awareness of this possible phenomenon in the setting of angleclosure.
Endoscopic Goniosynechialysis for AcuteAngleClosureGlaucoma Following Descemetâ€™s Stripping Automated Endothelial Keratoplasty We describe a new modified technique to release the peripheral iridocorneal adhesions that formed after Descemet stripping automated endothelial keratoplasty. The usual technique of goniosynechialysis was modified and performed using endoscopic fiber-optic light and camera probe to aid visualization of the adherent iris tissue and carry out uneventful 270 degrees (...) and improved quality of life. How to cite this article: Rana M, Shah S, Pandey P, Masood I. Endoscopic Goniosynechialysis for AcuteAngleClosureGlaucoma Following Descemet's Stripping Automated Endothelial Keratoplasty. J Curr Glaucoma Pract 2018;12(2):90-93.
Bilateral acuteangle-closureglaucoma following tramadol subcutaneous administration. To report a case of bilateral acuteangleclosure-glaucoma following the use of subcutaneous Tramadol.A 42-year-old healthy man with unremarkable past medical and ocular history, was admitted to the Orthopedic Department for surgical treatment of a bilateral open fracture of the femur following a road accident. Three hoursafterTramadolsubcutaneous injection, the patient complained of a bilateral acute painful (...) visual loss with persistent vomiting. An ocular examination showed bilateral acuteangle-closure-glaucoma. The patient was treated with topical anti-glaucoma therapy and intravenous Mannitol 20%.After resolution of ocular hypertension attack, NdYag laser peripheral iridotomy was performed on both eyes. After a follow-up period of 7 days visual acuity improved to 20/20 in both eyes and intraocular pressure returned to normal levels.This case highlights the risk of developing bilateral acuteangle
A Novel Association between Oxybutynin Use and Bilateral AcuteAngleClosureGlaucoma: A Case Report and Literature Review We are reporting a case of a 62-year-old male presenting with headache and blurry vision. His condition resolved with cessation of the presumed offending medication and urgent bilateral laser peripheral iridotomies since he failed medical therapy. This case presents a novel association between oxybutynin and bilateral acuteangle-closureglaucoma (AACG).
AcuteAngle-ClosureGlaucoma Caused by Venlafaxine 29893371 2018 12 11 2018 12 11 2542-5641 131 12 2018 Jun 20 Chinese medical journal Chin. Med. J. AcuteAngle-ClosureGlaucoma Caused by Venlafaxine. 1502-1503 10.4103/0366-6999.233952 Zhou Nan N Department of Pharmacy, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China. Zhao Jia-Xin JX Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China. Zhu Ya-Ning YN Department of Pharmacy, Shaanxi (...) Provincial People's Hospital, Xi'an, Shaanxi 710068, China. Zhang Peng P Department of Pharmacy, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China. Zuo Yan Y Department of Pharmacy, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China. eng Letter China Chin Med J (Engl) 7513795 0366-6999 0 Antidepressive Agents, Second-Generation 7D7RX5A8MO Venlafaxine Hydrochloride IM Acute Disease Antidepressive Agents, Second-Generation adverse effects Glaucoma, Angle-Closure chemically
The Seasonality of Acute Attack of Primary Angle-ClosureGlaucoma in Beijing, China In this study, the seasonality of acute attack of primary angle-closureglaucoma (PACG) was analysed. This retrospective case series included 283 patients (200 women, 83 men; mean age, 68.2 ± 10.3 years; range, 37-96 years) with acute attack of PACG from a university-based clinic over 4 years. Patients' age and sex, and the date and season of onset of PACG attack, were analysed. Descriptive analysis and von (...) Mises distribution were used for statistical analysis. The highest incidence of acute attack of PACG was observed in those aged 60-69 years (34.6%). Descriptive analysis showed that the incidence was greater in June and July for men, November for women, and November for the entire sample. An angular plot (using von Mises distribution) of the individual dates of onset revealed the estimated peak onset on September 11, November 8, and October 28 for men, women, and both, respectively. Integration
Miller Fisher syndrome with acuteangle-closureglaucoma as the first manifestation: A case report. There were no reports of Miller Fisher syndrome (MFS) with acuteangle-closureglaucoma as the first manifestation.A 78-year-old female patient was admitted to our hospital with pain in her left eye, blurred vision along with nausea, and vomiting for 2 days. It was extremely rare that ophthalmoplegia, loss of tendon reflexes, and ataxia, did not occur in the early stages of MFS, and initial (...) presentation was only dilated pupis and an increase in intraocular pressure.The final diagnosis of the patient was MFS.Intravenous immunoglobulins were administered.Ophthalmoplegia, walking instability, and ataxia gradually improved. At 3 months follow-up, there was no neurological deficit, and the patient could completely self-care.This is the first report of MFS patient with acuteangleclosureglaucoma as the first manifestation. Consideration should be given to the possibility of incorporating
Bilateral acute myopia and angleclosureglaucoma induced by Ma-huang (Ephedra): A case report. Cases of bilateral acuteangleclosure have been reported after use of various drugs.A 52-year-old woman visited the emergency room and complained of acute bilateral ocular pain and decreased vision accompanied by headache, nausea, and vomiting. One day before, she had started a herbal medicine containing Ma-huang for weight loss. On examinations, myopic shift, edematous cornea, increased intraocular (...) pressure, shallow anterior chamber, and thickened choroid on both eyes were observed.Angle closureglaucoma induced by drug (Ma-huang).To promptly quit the offending drug and apply ocular hypotensives and cycloplegics.Her symptoms and signs were relieved after antiglaucoma medications and no significant recurrence has been occurred.Physicians prescribing weight loss medications containing Ma-huang must be aware of the potentially sight-threatening adverse effect of bilateral acuteangle
AcuteAngle-ClosureGlaucoma as a First Presentation of Coats' Disease: A Case Report. The purpose of this study was to report an unusual first manifestation of Coats' disease presenting as an acuteangle-closureglaucoma attack in an adult patient.A 37-year-old African woman presented to the emergency department with severe headache, ocular pain, and no light perception in the left eye. The left pupil was middilated and nonreactive, and the intraocular pressure (IOP) by applanation tonometry (...) peripheral iridotomy to control the IOP, which had decreased to 21 mm Hg the following day. Diode laser transscleral cyclophotocoagulation was performed to further decrease the IOP. After completing a 360 degree laser, the IOP decreased to 8 mm Hg and then stabilized around 12 mm Hg. The vision remained no light perception; however, the patient felt major symptomatic relief.The present case describes acuteangle-closureglaucoma as an initial presentation of Coats' disease in adults. Clinicians should
AcuteAngleClosureGlaucoma Associated with Aripiprazole in the Setting of Plateau Iris Configuration. The purpose of this study was to report a novel case of drug-induced angle-closure from aripiprazole (Abilify), an atypical antipsychotic, and propose a mechanism for this association.We report a case of a 45-year-old white woman who presented in subacute angleclosure 2 months after initiating aripiprazole 5 mg daily for depression. This patient reported no prior ocular history and had been (...) of the angles in both eyes 1 week after cessation.This is the first report to describe drug-induced angle-closureglaucoma associated with aripiprazole use. The mechanism of angleclosure, we hypothesize, is from mydriasis and/or supraciliary effusion mediated by the serotoninergic effect on the iris and ciliary body complex. Treatment is preferably cessation of the medication. However, in cases where the medication is necessary for management of major depression, iridoplasty should be performed to reduce
A Rare Case of Topiramate Induced Secondary AcuteAngleClosureGlaucoma Secondary AcuteAngleClosureGlaucoma (AACG) is a known side effect of Topiramate (TPM). Here, we present a case report of a 47-year-old male who was started on TPM 25 mg/day for migraine. He presented to the ophthalmology department of our hospital with sudden blurring of vision and colored halos after one day of starting TPM. A high index of suspicion, followed by appropriate investigations and prompt management
Acuteangleclosureglaucoma secondary to polypoidal choroidal vasculopathy â€“ a devastating complication Acuteangleclosureglaucoma (ACG) in the setting of polypoidal choroidal vasculopathy (PCV) is a catastrophic complication that has been documented infrequently in literature. Ours is the second only report that describes hemorrhagic choroidal detachment as an event leading to acuteangleclosureglaucoma in PCV patients and the first one to describe the use of diode cyclophotocoagulation (...) (CPC) for this condition. The purpose of this article is to familiarize readers with this entity that has an extremely dismal visual prognosis. Ours is a descriptive case report of two patients with PCV complicated by sudden onset hemorrhagic choroidal detachment (CD) and acute ACG. Both patients had severe pain with no perception of light at presentation with an acuteangleclosure attack. Both underwent diode CPC for pain relief and control of intraocular pressure (IOP). Both our patients did
AcuteAngleClosureGlaucoma in a Patient with Pseudoxanthoma Elasticum 28914006 2017 12 26 2018 11 13 2092-9382 31 5 2017 10 Korean journal of ophthalmology : KJO Korean J Ophthalmol AcuteAngleClosureGlaucoma in a Patient with Pseudoxanthoma Elasticum. 462-463 10.3341/kjo.2017.0042 Han Jung Yeob JY Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. Lee Chong Eun CE Department of Ophthalmology, Dongsan Medical Center, Keimyung (...) University School of Medicine, Daegu, Korea. Kim Yu Cheol YC Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. email@example.com. eng Case Reports Letter 2017 08 29 Korea (South) Korean J Ophthalmol 8804513 1011-8942 IM Acute Disease Anterior Chamber diagnostic imaging Female Glaucoma, Angle-Closure diagnosis etiology physiopathology Humans Intraocular Pressure Middle Aged Photography Pseudoxanthoma Elasticum complications diagnosis physiopathology
Atypical Presentation of AcuteAngle-ClosureGlaucoma in Maroteaux-Lamy Mucopolysaccharidosis with Patent Prophylactic Laser Peripheral Iridotomy: A Case Report Maroteaux-Lamy syndrome (MLS) is a rare progressive condition characterized by inflammation and scarring of multiple organs. Ocular complications caused by anterior segment abnormalities commonly cause visual impairment in MLS. Angle-closureglaucoma is one such complication, but there are limited data on presentation, workup (...) , and management of this condition.This case report describes an atypical presentation of acuteangle-closureglaucoma in a patient with MLS despite a prior prophylactic laser peripheral iridotomy-which would typically prevent an acuteangle-closure attack-that was patent and intact at the time of angle closure.Because of severe congenital anterior segment crowding, high axial hyperopia, and constant accommodative demand in patients with MLS, we recommend performing two prophylactic laser peripheral