H40.063 Primary angle closure without glaucoma damage, bilateral

ICD10CM code

#### Name of the Condition
- **Primary Angle Closure without Glaucoma Damage, Bilateral (ICD-10: H40.063)**
- Also known as: Angle Closure without Glaucoma in Both Eyes.

#### Summary
Primary angle closure without glaucoma damage refers to a condition where there is increased intraocular pressure in both eyes due to a closure of the drainage angle in the eye, but without any detectable damage to the optic nerve or loss of vision typically associated with glaucoma.

#### Causes
- This condition occurs when the iris is pushed forward or the lens thickens, blocking the drainage angle of the eye. It is often related to anatomical predispositions that lead to narrowed angles between the iris and the cornea.

#### Risk Factors
- **Age**: More common in individuals over 40.
- **Family History**: Genetic predispositions can increase risk.
- **Ethnicity**: Higher prevalence in Asian, Inuit, and Hispanic populations.
- **Refractive Errors**: Farsightedness increases narrower anatomical angles risk.

#### Symptoms
- May not present noticeable symptoms until significant pressure buildup occurs.
- Early signs could include mild headaches, blurred vision, or seeing halos around lights.

#### Diagnosis
- Comprehensive eye examination, including:
  - **Gonioscopy**: To assess the drainage angle in the eye.
  - **Tonometry**: Measurement of intraocular pressure.
  - **Optical Coherence Tomography (OCT)**: Provides detailed images of the eye structure.

#### Treatment Options
- **Medications**: To lower eye pressure, such as topical beta-blockers or alpha agonists.
- **Laser Therapy**: Laser peripheral iridotomy to create an alternative drainage pathway.
- **Surgical Procedures**: In some cases, lens extraction might be recommended.

#### Prognosis and Follow-Up
- If managed properly, patients can maintain normal vision without progression to glaucoma.
- Regular ophthalmologic evaluations are crucial to monitor eye pressure and drainage angle status.

#### Complications
- If untreated, there is a risk of progression to acute angle-closure glaucoma and permanent vision loss.

#### Lifestyle & Prevention
- Regular eye exams, especially if you have risk factors.
- Stay hydrated, and avoid overuse of corticosteroids unless prescribed.

#### When to Seek Professional Help
- Immediate medical attention is required if sudden onset of vision changes, severe eye pain, or nausea occurs, as these may indicate acute angle-closure.

#### Additional Resources
- [American Academy of Ophthalmology](https://www.aao.org)
- [Glaucoma Research Foundation](https://www.glaucoma.org)

#### Tips for Medical Coders
- Ensure to specify "without glaucoma damage" and "bilateral" to align with the ICD code H40.063.
- Common error to avoid is confusing with conditions involving glaucoma damage or affecting only one eye.

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