Classification and management of patients with narrow or closed angles

Developments in the technique of gonioscopy and increased understanding of the mechanism of angle closure has made possible a more precise definition of "narrow-angle" and "closed-angle" glaucoma. It is, however, still not possible to predict with certainty which narrow angles will close spontaneously and which will not. A new classification of these conditions is suggested: Asymptomatic narrow angle; asymptomatic primary closed angle; symptomatic primary closed angle; fellow eye of symptomatic closed angle; narrow angle associated with chronic open-angle glaucoma; closed angle in previous chronic open-angle glaucoma; secondary angle closures. Recognition of these different types permits individualized and in most cases highly effective therapy.