Codes / ICD10CM / H40.123

H40.123 Low-tension glaucoma, bilateral

ICD10CM code

ICD10CM

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Name of the Condition

  • Low-tension glaucoma, bilateral

Summary

Low-tension glaucoma is a form of open-angle glaucoma where optic nerve damage occurs despite normal intraocular pressure levels. It affects both eyes (bilateral) and progresses slowly, potentially leading to vision loss if untreated.

Causes

The exact cause is not fully understood but may involve reduced blood flow to the optic nerve or increased susceptibility of the nerve to typical pressure levels.

Risk Factors

  • Family history of glaucoma
  • Cardiovascular conditions affecting blood flow
  • Migraine headaches
  • Certain ethnic backgrounds (e.g., Japanese ancestry)

Symptoms

  • Gradual loss of peripheral vision in both eyes
  • Difficulty seeing in low light
  • Advanced cases may cause tunnel vision

Diagnosis

Diagnosis involves comprehensive eye exams, including visual field tests, optic nerve imaging, and tonometry to confirm normal intraocular pressure despite nerve damage.

Treatment Options

  • Medications: Eye drops to lower pressure or improve blood flow
  • Laser therapy: To enhance fluid drainage
  • Surgery: For severe cases to create new drainage paths

Prognosis and Follow-Up

Prognosis varies; timely treatment can slow or halt progression. Regular follow-ups are essential to monitor nerve health and adjust therapy as needed.

Complications

  • Progressive vision loss
  • Blindness in advanced stages
  • Reduced quality of life due to vision impairment

Lifestyle & Prevention

  • Maintain regular eye exams, especially if risk factors exist
  • Manage cardiovascular health to support optic nerve blood flow
  • Avoid smoking, which may worsen blood flow to the eyes

When to Seek Professional Help

Seek immediate care if you experience sudden vision changes, severe eye pain, or rapid vision loss, as these may indicate acute complications.

Tips for Medical Coders

Document bilateral involvement clearly in clinical notes. Ensure the diagnosis confirms normal intraocular pressure alongside optic nerve damage to support the use of H40.123.

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