Primary XXXX : an update.

@entity1 @entity1539 @entity231 @entity726 @entity1939 @entity1897 @entity2747 @entity616
UNASSIGNED: Primary @entity2747 is potentially a devastating disease, responsible for half of @entity726 -related @entity1939 worldwide. Angle closure is characterized by appositional approximation or contact between the iris and trabecular meshwork. It tends to develop in eyes with shallow anterior chambers, anteriorly positioned or pushed lenses, and angle crowding. Risk of primary @entity2747 is high among @entity1 , the elderly and the hyperopic, and it is most prevalent in Asia. Investigation into genetic mechanisms of @entity726 inheritance is underway. Diagnosis relies on gonioscopy and may be aided by anterior segment optical coherence tomography and ultrasound biomicroscopy. Treatment is designed to control intraocular pressure while monitoring changes to the angle and optic nerve head. Treatment typically begins with medical management through pressure-reducing topical medications. @entity1897 is often performed to alleviate @entity616 , while laser iridoplasty has been found effective for mechanisms of closure other than @entity616 , such as @entity1539 . Phacoemulsification, with or without goniosynechialysis, both in eyes with existing @entity231 and in those with clear lenses, is thus far a viable treatment alternative. Long-term research currently underway will examine its efficacy in cases of angle closure in early stages of the disease. Endoscopic cyclophotocoagulation is another treatment option, which can be combined with @entity231 surgery. Trabeculectomy remains effective therapy for more advanced cases.
