Primary Angle-Closure Glaucoma (PACG): Understanding the Condition and Its Treatment

Primary angle-closure glaucoma (PACG) is a type of glaucoma caused by the closing of the angle where the iris and cornea meet. This closing of the angle blocks the flow of aqueous humor, the fluid that nourishes the eye, leading to increased pressure inside the eye (intraocular pressure or IOP) and damage to the optic nerve. If left untreated, PACG can lead to blindness.

Symptoms and Causes of PACG

Symptoms of PACG can include sudden onset of severe eye pain, headache, blurred vision, halos around lights, and nausea. The cause of PACG is related to the anatomy of the eye, specifically a narrow angle between the iris and cornea. This narrow angle can be caused by a variety of factors such as age, hyperopia (farsightedness), and certain types of cataracts.

Diagnosis and Treatment of PACG

PACG is typically diagnosed through a comprehensive eye exam, including measuring the IOP, examining the angle of the eye, and examining the optic nerve. Gonioscopy, a procedure that allows the doctor to see the angle of the eye, is also done to confirm the diagnosis.

The main goal of treatment for PACG is to lower the IOP and protect the optic nerve. This may include medications such as ocular hypotensive agents, which lower the IOP, and laser therapy such as laser peripheral iridotomy (LPI), which creates a small hole in the iris to allow the aqueous humor to flow more freely.

In some cases, surgery may be recommended. The most common surgery for PACG is Trabeculectomy, a procedure that creates a new drainage channel for the aqueous humor to flow out of the eye, lowering the IOP.

Monitoring

PACG is a chronic condition that requires regular monitoring to ensure that the treatment plan is effective. The patient will need to have regular eye exams to check the IOP, angle of the eye, and visual field. If the treatment is not effective, the treatment plan may need to be adjusted.

Prevention

While there is no known way to prevent PACG, early detection and treatment can help slow the progression of the disease. It is important to have regular eye exams, especially if you have a family history of glaucoma or other risk factors such as age above 40, hyperopia, or certain types of cataracts.

In conclusion, Primary Angle-Closure Glaucoma (PACG) is a type of glaucoma caused by the closing of the angle where the iris and cornea meet. This closing of the angle blocks the flow of aqueous humor, leading to increased pressure inside the eye and damage to the optic nerve. The main goal of treatment is to lower the IOP and protect the optic nerve. This may include medications, laser therapy, and surgery. Regular monitoring is essential to ensure that the treatment plan is effective and to adjust it if needed. Preventive measures include regular eye exams, especially for people with risk factors for PACG.

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