Name of the Condition

• Chronic Angle-Closure Glaucoma, Bilateral, Severe Stage
• Also known as acute angle-closure glaucoma when sudden, or narrow-angle glaucoma.

Summary

Chronic angle-closure glaucoma is a condition where the drainage angle formed by the cornea and iris closes, leading to increased eye pressure, gradually damaging the optic nerve. In severe bilateral cases, both eyes are affected, potentially leading to significant visual impairment if untreated.

Causes

• The main cause is the structural defect in the eye, where the angle between the iris and cornea is too narrow.
• Eye trauma, cataracts, and swelling can also contribute by blocking drainage pathways.

Risk Factors

• Age: More common in individuals over 40.
• Ethnicity: Higher prevalence in Asian and Inuit populations.
• Gender: Women are at greater risk than men.
• Family History: Genetic predisposition increases risk.
• Hyperopia: Farsightedness can predispose individuals to this condition.

Symptoms

• Gradual loss of peripheral vision in both eyes.
• Severe eye pain and headaches.
• Halos around lights.

• Nausea or vomiting accompanying eye pain.

  Diagnosis

• Tonometry: Measures eye pressure.
• Gonioscopy: Examines the drainage angle of the eye.
• Ophthalmoscopy: Checks optic nerve damage.
• Visual Field Test: Identifies vision loss areas.

Treatment Options

• Medications: Eye drops and oral medications reduce eye pressure.
• Laser Therapy: Laser peripheral iridotomy creates a small hole in the iris to improve fluid drainage.
• Surgery: Trabeculectomy or cataract extraction may be necessary for severe cases.

Prognosis and Follow-Up

• With early diagnosis and treatment, progression can be halted, preserving vision.
• Lifelong monitoring is essential to manage eye pressure.
• Regular follow-up with an ophthalmologist is crucial to avoid complications.

Complications

• If untreated, can lead to permanent blindness.
• Possible development of acute angle-closure attacks.

Lifestyle & Prevention

• Regular eye exams for early detection, especially for high-risk groups.
• Controlling systemic health conditions such as hypertension or diabetes.
• Nutrition like a diet rich in green, leafy vegetables may support eye health.

When to Seek Professional Help

• Immediate attention for sudden vision changes, severe eye pain, or headache.
• Prompt consultation for persistent symptoms.

Additional Resources

• American Academy of Ophthalmology (AAO): aao.org
• Glaucoma Research Foundation: glaucoma.org

Tips for Medical Coders

• Ensure correct identification of bilateral involvement and severe stage.
• Use appropriate codes for related conditions or symptoms.
• Avoid confusing with open-angle glaucoma, which has distinct coding.