Treatment of the fellow eye in acute angle-closure glaucoma: a case report and survey of members of the American Glaucoma Society.

PURPOSE: A survey of members of the American Glaucoma Society was compiled to determine the treatment practices of subspecialty-trained glaucoma specialists regarding the treatment of the fellow eye in acute angle-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 glaucoma and in whom definitive prophylactic laser iridotomy was temporarily deferred; her eye developed acute angle-closure glaucoma despite treatment with pilocarpine.

RESULTS

One hundred fifty-five of the 200 mailed 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 subspecialty-trained glaucoma specialists as the treatment of the fellow eye in cases of acute angle-closure glaucoma when laser iridotomy is temporarily deferred. The present case reminds us that the fellow eye is highly susceptible to acute angle closure glaucoma and that prophylactic laser iridotomy should be performed at the earliest possible juncture.