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Glaucoma de ângulo fechado

Last reviewed: 22 Jul 2025
Last updated: 20 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • halos ao redor de luzes
  • dor no olho ou na sobrancelha
  • cefaleia
  • náuseas e vômitos
  • acuidade visual reduzida
  • vermelhidão no olho
  • pressão intraocular elevada (PIO)
  • edema da córnea
  • pupila dilatada fixa
Full details

Other diagnostic factors

  • achados oculares acidentais
  • visão turva
  • histerese da córnea
  • alteração na visão
Full details

Risk factors

  • sexo feminino
  • hiperopia
  • câmara anterior periférica rasa
  • fechamento angular no segundo olho
  • etnias inuíte e asiática
  • idade avançada
  • história familiar
  • uso de medicamentos que induzem o estreitamento do ângulo
  • histerese da córnea
Full details

Diagnostic investigations

1st investigations to order

  • gonioscopia, exame do ângulo da câmara anterior
  • exame com lâmpada de fenda
  • perimetria estática automática
Full details

Investigations to consider

  • biomicroscopia ultrassônica
  • tomografia de coerência óptica do segmento anterior (do ângulo)
  • avaliação da cabeça do nervo óptico por fundoscopia
  • tomografia de coerência óptica retiniana
  • tomografia retiniana de Heidelberg
  • analisador de fibras nervosas GDx
Full details

Emerging tests

  • histerese da córnea

Treatment algorithm

ACUTE

apresentação inicial: glaucoma agudo de ângulo fechado

apresentação inicial: glaucoma crônico de ângulo fechado

ONGOING

fechamento angular residual após iridotomia periférica a laser com pressão intraocular elevada

episódio repetido de glaucoma agudo de ângulo fechado

Contributors

Authors

Brian A. Francis, MD, MS

Riffenburgh Professorship in Glaucoma

Associate Professor of Ophthalmology

Doheny Eye Institute

Department of Ophthalmology

Keck School of Medicine

University of Southern California

Los Angeles

CA

Disclosures

BAF declares that he has no competing interests.

Stephanie Midtling, MD

Glaucoma Fellow

Department of Ophthalmology

UCLA Stein Eye Institute

Doheny Eye Centers UCLA

Los Angeles

CA

Disclosures

SM declares that she has no competing interests.

Acknowledgements

Dr Brian A. Francis and Dr Stephanie Midtling would like to gratefully acknowledge Dr Ani Khondkaryan, Dr Yaniv Barkana, and Dr Noa Chetrit, previous contributors to this topic. AK, YB, and NC declare that they have no competing interests.

Peer reviewers

Gus Gazzard, MA, MBBChir, MD, FRCOphth

Consultant Ophthalmic Surgeon

King's College Hospital

Honorary Research Fellow

Institute of Ophthalmology

London

UK

Disclosures

GG declares that he has no competing interests.

Edward J. Rockwood, MD

Associate Professor of Ophthalmology

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

Cole Eye Institute

Cleveland Clinic

Cleveland

OH

Disclosures

EJR has received one honorarium from Pfizer, Inc. (manufacturers of Xalatan) for a speaking engagement.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Academy of Ophthalmology. Preferred practice pattern: primary angle closure. November 2020 [internet publication].Full text

International Council of Ophthalmology. ICO guidelines for glaucoma eye care. February 2016 [internet publication]Full text

American Academy of Ophthalmology. ​Glaucoma summary benchmarks - 2023. Dec 2023 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

    • Glaucoma de ângulo aberto (primário e secundário)
    • Outras neuropatias ópticas (por exemplo, compressiva)
    • Trauma ocular
    More Differentials
  • Guidelines

    • Glaucoma summary benchmarks - 2023
    • Vision rehabilitation preferred practice pattern
    More Guidelines
  • Patient information

    Glaucoma (ângulo aberto)

    More Patient information
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