Treatment for First degree angle closure glaucoma is
C i.e. Laser Irodotomy Laser Irodotomy is the treatment of choice for PACG, but is successful only if less than 180deg (50% )of the angle is closed. So it is effective in first degree angle closure glaucoma. But it may be difficult until the corneal thickening & iris congestion have settled (usually 48 hours). The Shaffer grading system The system of angle grading which is used almost universally today records the angle in degrees of arc subtended by the inner surface ofthe trabecular meshwork and anterior surface of the iris about one-third of the distance from its periphery. Grade Angle Description Grade 4 (35-45deg) The widest angle characteristic of myopia and aphakia in which the ciliary body can be visualized with ease; it is incapable of closure. Grade 3 (25-35deg) Open angle in which at least the scleral spur can be identified; it is also incapable of closure Grade 2 (20deg) Moderately narrow angle in which only the trabeculum can be identified; angle closure is possible but unlikely Grade 1 (10deg) Very narrow angle in which only Schwalbe line, and perhaps also the top of the trabeculum, can be identified; angle closure is not inevitable but the risk is high Slit angle One in which there is no obvious irido-corneal contact but no angle structures can be identified; this angle has the greatest danger of imminent closure Grade 0 (0deg) Closed angle due to iridocorneal contact and is recognized by the inability to identify the apex of the corneal wedge
Trabeculectomy
Pilocarpine
Laser Irodotomy
Timolol