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Gonioscopy (separate procedure)

CPT4 code

Name of the Procedure:

Gonioscopy

Summary

Gonioscopy is a diagnostic eye procedure that allows doctors to examine the angle where the iris meets the cornea. This crucial area, known as the anterior chamber angle, plays a vital role in fluid drainage from the eye. A special lens is used during the examination to get a detailed view of this part of the eye, which is not visible through routine inspection methods.

Purpose

Gonioscopy is used to evaluate the anterior chamber angle for defects or abnormalities that could indicate or contribute to glaucoma. The goals are to identify potential blockages or anatomical issues and to assess the effectiveness of treatments for glaucoma.

Indications

  • Symptoms of glaucoma such as blurred vision, eye pain, or halos around lights.
  • Increased intraocular pressure noted during an eye exam.
  • Family history of glaucoma.
  • Assessment required prior to certain eye surgeries.

Preparation

  • No special preparation is typically required.
  • Patients may need to stop using certain eye medications on the day of the procedure.
  • The doctor might conduct a preliminary eye examination and measure intraocular pressure beforehand.

Procedure Description

  1. The patient is seated at a slit lamp (a special microscope with a light).
  2. Numbing eye drops are administered to ensure comfort.
  3. A gonioscopy lens (a specialized contact lens) is gently placed on the eye.
  4. The doctor uses the slit lamp to view the anterior chamber angle through the lens.
  5. The examination takes a few minutes, and the doctor may ask the patient to look in different directions to get multiple views.

Duration

The entire procedure typically takes about 10 to 15 minutes.

Setting

Gonioscopy is usually performed in an outpatient eye clinic.

Personnel

  • Ophthalmologist

Risks and Complications

  • Temporary discomfort or irritation in the eye.
  • Rarely, a minor scratch on the cornea.
  • Slight risk of infection or allergic reaction to the numbing drops.

Benefits

  • Provides crucial information on the health of the eye’s drainage system.
  • Helps in diagnosing and managing glaucoma.
  • Non-invasive and quick procedure.

Recovery

  • Normal activities can generally be resumed immediately.
  • Mild irritation or blurry vision may occur temporarily but usually resolves within a few hours.
  • Follow-up appointments might be necessary based on the findings.

Alternatives

  • Optical Coherence Tomography (OCT) of the anterior segment.
  • Ultrasound Biomicroscopy (UBM).
  • Each alternative has its pros and cons, and often, gonioscopy provides more direct and definitive visualization of the angle structures.

Patient Experience

During the procedure, the patient might feel slight pressure from the contact lens but should not experience significant pain. Discomfort is usually minimal due to the numbing drops. Post-procedure, vision may be blurry or slightly uncomfortable, but these effects are typically short-lived. Pain management is generally unnecessary, but artificial tears can help alleviate any residual dryness or irritation.

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