Our Summary

This research paper revolves around a 65-year-old man who only has vision in one eye and was treated for a total knee replacement surgery. The surgery went smoothly, but the next day he started experiencing continuous pain around his eye, redness, and blurred vision. The doctors diagnosed him with Acute angle closure glaucoma (AACG), a condition where the pressure inside the eye increases rapidly. This condition was treated without any surgical procedures, by just reducing the pressure in the eye.

The paper mentions that in cases of AACG following surgery, certain factors like genetic predisposition, being female, having a certain eye condition (hypermetropia), having a thicker lens, or a smaller corneal diameter may increase the risk. Additionally, the use of certain drugs during anesthesia, which can block the pupil, can also lead to AACG.

The key takeaway is that doctors should be aware that severe and sudden pain around the eye, with or without vision disturbance, could be a sign of AACG, especially after surgery.

FAQs

  1. What is Acute angle closure glaucoma (AACG) and how is it diagnosed?
  2. What are the risk factors for post-operative AACG?
  3. How is AACG treated after surgery to reduce intraocular pressure?

Doctor’s Tip

It is important to follow your doctor’s post-operative instructions carefully, including taking any prescribed medications and attending follow-up appointments. If you experience any sudden or severe eye pain, changes in vision, or redness in the eye after glaucoma surgery, contact your doctor immediately as these could be signs of complications such as acute angle closure glaucoma. Early detection and treatment are key to a successful outcome.

Suitable For

Patients who are typically recommended for glaucoma surgery are those who have failed to respond to medications or other treatments, have severe symptoms or complications from their glaucoma, have a progressive form of the disease, or have a high risk of vision loss. Additionally, patients with certain types of glaucoma, such as angle closure glaucoma or secondary glaucoma, may also be recommended for surgery.

Timeline

Before glaucoma surgery:

  • Patient may experience symptoms such as blurred vision, halos around lights, eye pain, headache, and nausea.
  • Patient undergoes a thorough eye examination, including measurement of intraocular pressure, visual field testing, and examination of the optic nerve.
  • Diagnosis of glaucoma is confirmed and treatment options are discussed with the patient.
  • Patient may be prescribed medications to lower intraocular pressure or undergo laser therapy to improve drainage of fluid from the eye.

After glaucoma surgery:

  • Patient undergoes the surgical procedure, which may involve creating a new drainage pathway for fluid in the eye or implanting a device to improve drainage.
  • Patient may experience some discomfort and blurry vision immediately following surgery.
  • Patient is monitored closely for any complications, such as infection or increased intraocular pressure.
  • Patient may need to use eye drops or other medications to prevent infection and promote healing.
  • Follow-up appointments are scheduled to monitor the success of the surgery and make any necessary adjustments to the treatment plan.

What to Ask Your Doctor

  1. What are the benefits of glaucoma surgery for my condition?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the success rate of the surgery in terms of improving my vision and reducing intraocular pressure?
  4. What is the recovery process like after glaucoma surgery?
  5. Will I need to take any medication or follow a specific treatment plan after the surgery?
  6. How long will it take for me to see improvement in my symptoms after the surgery?
  7. Are there any lifestyle changes I should make to help improve the outcome of the surgery?
  8. How often will I need to follow up with you after the surgery for monitoring and evaluation?
  9. Are there any alternative treatments or procedures that I should consider before opting for glaucoma surgery?
  10. What should I do if I experience any unusual symptoms or complications after the surgery?

Reference

Authors: Ketata S, Zouche I, Derbel R, Dammak R, Kolsi H, Bousabbeh A, Ketata O. Journal: Pan Afr Med J. 2022 Jan 25;41:68. doi: 10.11604/pamj.2022.41.68.31888. eCollection 2022. PMID: 35371375