A CLINICAL STUDY OF PRIMARY ANGLE CLOSURE GLAUCOMA SUSPECT IN RURAL HOSPITAL, PES INSTITUTE OF MEDICAL SCIENCES AND RESEARCH, KUPPAM
ABSTARCT This study was undertaken to determine the possibility of identifying eyes, that were at risk of developing spontaneous angle closure glaucoma, so that, they could be protected from of an acute attack of angle closure. The risks of peripheral iridotomy are less than the dangers of an acute attack of angle-closure, prophylactic intervention (laser PI) can be tried to prevent visual impairment and morbidity arising from it. In the present study, 114 eyes of 57 patients, who were having
... , who were having high risk for development of angle closure glaucoma were selected by routine history and relevant examination, then results were analysed and discussed. In the present study, 76 eyes were found to have occludable angles, prophylactic laser peripheral iridotomy was done for 30 patients who are willing for treatment. The van herick test has been suggested as a screening test for angle closure. The sensitivity and specificity of this test are such that a negative test does not rule out angle closure and a positive test still requires a gonioscopy. The presence of a positive van Herrick and a raised IOP is highly specific and almost pathognomonic of closure, but gonioscopy is still required for management. Angle imaging techniques, such as the ultrasound bio-microscope and anterior segment optical coherence tomography (OCT) have not replaced gonioscopy and are not necessary for routine clinical use. On the basis of the results of this study, although the measurement of peripheral anterior chamber depth is believed to be useful for glaucoma screening, ophthalmologist utilizing gonioscope should make the final assessment. It is necessary to develop an affordable and non-invasive method for enabling non physicians to evaluate anterior chamber angle as well as testing equipment that allows narrow angle eyes and PACG eyes to be detected easily, safely, and reliably. For primary angle closure (PAC) or early primary angle closure glaucoma, case detection presents the unique opportunity to prevent blindness from glaucoma. In order to achieve that goal, detection of "early" disease (PAC; early PACG) prior to functional loss is important in primary angle closure disease.