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CORNEA
Current Updates Of Ophthalmologic Disorders And
Managements For Physicians And Medical
Students
Angle Closure
Symptoms
Mechanism
How to Manage
Signs
APAC?
Corneal
Elevated IOP
Ciliary and edema Treatment
conjunctival
injection • Eliminate block pupil
Middilated Decreased History • Reduce IOP
pupil
visual acuity
Mild AC Examination
Shallow inflammation
anterior
chamber
Eliminating Block
Reducing IOP (3/3)
Pupil
Topical antiglaucoma • Miotics (e.g., pilocarpine 2%)
• Beta blockers • Break an early angle-closure attack, ineffective if the
• Selective alpha agonists iris is already ischemic
• Avoid High-concentration miotics (e.g., pilocarpine
• Carbonic anhydrase inhibitors 4%) : forward displacement iris-lens diaphragm
• Prostaglandin analogues – unreliable effect in acute attack • Definitive treatment refer to ophthalmologist
because of slow onset of action • Laser iridotomy
• Reduce Inflammation: topical steroids • Cataract extraction: phaco
Laser Peripheral
Iridotomy
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