What patient education should I provide regarding the risk factors and prevention of acute angle-closure glaucoma?

Patient education regarding risk factors and prevention strategies for acute angle-closure glaucoma should include the following key points:

• Risk Factors: Explain that acute angle-closure glaucoma is related to anatomical features such as a shallow anterior chamber and narrow angles, which increase the risk of sudden intraocular pressure (IOP) elevation. Family history of glaucoma is also important, as glaucoma can run in families and relatives may need testing.
• Symptom Awareness: Inform patients that acute angle-closure glaucoma can present suddenly with symptoms such as eye pain, headache, nausea, blurred vision, and halos around lights, and that it is an ophthalmic emergency requiring immediate medical attention.
• Prevention Strategies: Advise patients at risk to avoid medications that can dilate the pupil (mydriatics) without medical supervision, as pupil dilation can precipitate angle closure.
• Regular Monitoring: Emphasize the importance of regular eye examinations, including assessment of anterior chamber depth and angle status (e.g., gonioscopy or van Herick test), to detect narrow angles before an acute attack occurs.
• Early Intervention: Explain that if narrow angles are detected, preventive treatments such as laser peripheral iridotomy may be offered to reduce the risk of an acute attack.
• Role in Treatment: Stress the importance of adherence to any prescribed treatments and attending scheduled monitoring appointments to preserve sight.

Providing information in an accessible format and allowing patients to discuss their condition and concerns supports shared decision-making and improves outcomes.

References: This advice aligns with NICE guidance on glaucoma diagnosis and management, which highlights the importance of patient education on glaucoma types, risk factors, symptomlessness of early disease, family risk, and the need for regular monitoring and treatment adherence ¹.