Clinical Practice Guidelines on Glaucoma (JGS, 2023)

Japan Glaucoma Society

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

April 05, 2023

Updated clinical practice guidelines for glaucoma were published in March 2023 by the Japan Glaucoma Society in the Japanese Journal of Ophthalmology.[1]

Initiate treatment in those who have ocular hypertension and risk factors for the development of primary open-angle glaucoma (POAG) from ocular hypertension, including advanced age, large vertical cup-to-disc (C/D) ratio, high intraocular pressure (IOP), large pattern standard deviation, thin central corneal thickness, and the occurrence of optic nerve disc hemorrhage.

Treatment with local anti-inflammatory medications, including the instillation of steroids, is beneficial for control of IOP after trabeculectomy for POAG and is strongly recommended.

Antimicrobial ophthalmic solution and ointment should be used continuously for a period after trabeculectomy. For the long term, use antimicrobial ophthalmic solution and ointment as appropriate based on the patient’s risk for bleb-related infection.

Cataract surgery should be the first-line treatment for primary angle closure glaucoma (PACG) and primary angle closure (PAC). Lens extraction can be used for first-line treatment regardless of whether the patient has symptomatic cataracts, but “it is not an absolute first-line treatment,” according to the authors, and the choice to use laser therapy should be made based on each patient’s situation. The indication for treatment of patients with PAC and normal IOP should be carefully weighed.

Intervention is strongly recommended for fellow eyes of acute primary angle-closure (APAC)-affected eyes.

For more information, please go to Acute Angle-Closure Glaucoma (AACG), Primary Open-Angle Glaucoma (POAG), Angle-Recession Glaucoma, Juvenile Glaucoma, Low-Tension Glaucoma, Neovascular Glaucoma, Primary Angle-Closure Glaucoma, Primary Congenital Glaucoma, and Secondary Congenital Glaucoma.


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