Contemporary Approach to Narrow Angles

Glaucoma is the leading cause of irreversible blindness worldwide. Among all glaucoma types,primary angle closure glaucoma (PACG) affects approximately 23 million people worldwide, andis responsible for 50% of glaucoma-related blindness, highlighting the devastating consequencesof this disease. The main mechanism of PACG is relative pupillary block. High-risk populations arefemale gender, Asian ethnicity, high hyperopia, short axial length, and a thick/anteriorly positionedlens. This review discusses the clinical diagnosis, classification, and management of patients witha narrow angle with and without intraocular pressure (IOP) elevation and glaucomatous opticnerve damage, including laser peripheral iridotomy (LPI), endocycloplasty (ECPL), lens extraction,and goniosynechialysis.