Primary Angle Closure Observed During a House Visit: A Case Treated With Laser Iridotomy

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Innovation

Background:

• Primary angle closure (PAC) poses a risk for elevated intraocular pressure (IOP) and vision loss.
• Traditional treatments for PAC may be challenging for elderly or socially constrained patients.
• Laser iridotomy (LI) is a standard procedure for specific pupillary block mechanisms.

Observation:

• A 97-year-old female with mild dementia and limited mobility presented with symptoms suggestive of PAC.
• Ophthalmologic evaluation revealed elevated IOP (24-26 mmHg), shallow anterior chambers, and cataracts.
• The patient was deemed unsuitable for frequent follow-up appointments required for medical or surgical interventions.

Findings:

• Laser iridotomy (LI) was successfully performed on both eyes.
• Post-procedure, IOP significantly decreased to 12 mmHg bilaterally within one week.
• No complications were observed following the LI procedure.

Implications:

• Laser iridotomy (LI) can be a safe and effective treatment for PAC and elevated IOP in patients with social or logistical challenges.
• This case highlights the adaptability of LI as a therapeutic option beyond typical indications.
• LI offers a valuable alternative for managing glaucoma-related conditions in underserved or complex patient populations.