Follow-up
Î The fellow eye of a patient with AACC should be evaluated, because it
is at high risk for a similar event. The fellow eye should be scheduled
for a prophylactic laser iridotomy promptly if the chamber angle is
anatomically narrow, since approximately half of fellow eyes of acute
angle-closure patients can develop AACCs within 5 years. (II++, G, S)
• These attacks can occur within days of presentation and, therefore, an
ophthalmologist should consider LPI in the fellow eye as soon as possible. (III, M, S)
Î Eyes with recurrent high IOP after iridotomy when the pupil is dilated
(plateau iris syndrome) should undergo further therapy, including
iridoplasty, chronic miotic therapy, or other surgical procedures.
(II+, M, D)
Î With or without glaucomatous optic neuropathy, patients with a residual
open angle or a combination of open angle and some PAS should be
followed at appropriate intervals to check for increasing PAS. (III, I, D)
Provider and Setting
Î The performance of certain diagnostic procedures (e.g., tonometry,
perimetry, pachymetry, anterior segment imaging, optic disc imaging,
and photography) may be delegated to appropriately trained and
supervised personnel. However, the interpretation of results and medical
and surgical management of disease require the medical training,
clinical judgment, and experience of the ophthalmologist. (G, S)
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