This protocol covers a specific early structural risk state: gonioscopy showing ≥180 degrees of iridotrabecular contact, but with normal intraocular pressure, no peripheral anterior synechiae, and no glaucomatous optic neuropathy — a configuration known as a primary angle-closure suspect (PACS).
Gonioscopy confirms ≥180° of iridotrabecular contact (ITC). Intraocular pressure is within normal limits. No peripheral anterior synechiae (PAS) are identified. There is no evidence of glaucomatous optic neuropathy. This constellation defines a primary angle-closure suspect (PACS) — an eye at structural risk despite the current absence of pressure elevation or optic nerve damage.
In this setting, a laser procedure targeting the peripheral iris is considered to reduce the risk of an acute angle-closure crisis or progression to more advanced angle-closure disease. The complete protocol specifies the clinical indication criteria, procedural details, and follow-up requirements.
The primary treatment goal is confirmation that the anterior chamber angle has opened, verified by repeat gonioscopy following intervention.