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closed (narrow)-angle glaucoma (NAG)

Etiology: - narrowed or occluded anterior chamber angle Epidemiology: - less common than open angle glaucoma Clinical manifestations: 1) increased intraocular pressure 2) optic nerve degeneration 3) visual field loss 4) insidious onset 5) blurred vision often attributed to needing new glasses Management: 1) pharmacologic agents: a) timolol maleate (Timoptic) 1 drop BID b) pilocarpine (Pilocar) 1 drop OU 6 times/day c) acetazolamide (Diamox) 250 mg PO QD-QID 2) laser trabeculoplasty a) useful in the elderly who may be unfit for surgery or anesthesia b) long term benefits questionable 3) surgery

Specific

acute angle-closure glaucoma aqueous misdirection glaucomatous flecks; glaukomflecken

General

primary glaucoma

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 66-67
  2. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004