Treatment of Primary Angle-Closure Glaucoma (PACG)

Primary Angle-Closure Glaucoma (PACG) is a type of glaucoma caused by the closing of the angle where the iris and cornea meet, 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. The goal of treatment for PACG is to lower the IOP and protect the optic nerve.

Medical Therapy

The first line of treatment for PACG is medical therapy. Medications such as ocular hypotensive agents, which lower the IOP, can be used to protect the optic nerve. These medications work by reducing the amount of aqueous humor produced by the eye or increasing the outflow of aqueous humor from the eye.

Laser Therapy

If medical therapy is not effective in controlling the IOP, laser therapy may be used. The most common laser therapy for PACG is laser peripheral iridotomy (LPI), which uses a laser to create a small hole in the iris to allow the aqueous humor to flow more freely. This procedure can improve the outflow of aqueous humor and lower the IOP.

Surgery

If laser therapy is not effective, surgery may be recommended. The most common surgery for PACG is trabeculectomy, which involves creating a new drainage channel for the aqueous humor to flow out of the eye. This can lower the IOP and reduce the pressure on the optic nerve.

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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