Medical and Surgical Treatment of Primary Angle Closure Glaucoma

Primary angle closure glaucoma occurs when pathologies in the relative/absolute sizes or positions of anterior segment structures or abnormal forces in the posterior segment structures apply pressure on the peripheral iris, causing iridocorneal angle closure and trabecular outflow blockage. Careful evaluation of the clinical status at hospital admission, the exact diagnosis and the underlying physiopathologic mechanism is crucial in determining the correct treatment option for the individual. The initial approach should aim to lower intraocular pressure using medical treatment options. Laser treatments should be performed thereafter, to prevent further angle closure episodes. Surgery should be considered in patients where intraocular pressure is unresponsive to conventional medical and laser treatments. This study reviews the medical, laser and surgical treatments in primary angle closure glaucoma.