TREATMENT OF THE FELLOW EYE IN ACUTE ANGLE-CLOSURE GLAUCOMA - A CASE-REPORT AND SURVEY OF MEMBERS OF THE AMERICAN-GLAUCOMA-SOCIETY

Purpose: 4 survey of members of the American Glaucoma Society was comp iled to determine the treatment practices of subspecialty-trained glau coma specialists regarding the treatment of the fellow eye in acute an gle-closure glaucoma. Methods: We surveyed 200 members of the American Glaucoma Society regarding treatment options for the fellow, eye of a patient with acute angle-closure glaucoma. The survey was mailed and was preceded by a case of a patient who had acute angle-closure glauco ma and in whom definitive prophylactic laser iridotomy was temporarily deferred; her eye developed acute angle-closure glaucoma despite trea tment with pilocarpine. Results: One hundred rifty-five of the 200 mai led surveys were answered and returned. Pilocarpine alone was the most common response category (50.3% of respondents), followed by observe/ close follow-up (32.9%). Other response categories were selected by <5 % of the respondents. Conclusion: Pilocarpine is well supported by the literature and by subspeciality-trained glaucoma specialists as: the treatment of the fellow eye in cases of acute angle-closure glaucoma w hen laser iridotomy is temporarily deferred. The present case reminds us thai the fellow, eye is highly susceptible to acute angle closure g laucoma and that prophylactic laser iridotomy should be performed at t he earliest possible juncture.