## **Core Concept**
Angle closure glaucoma is a medical emergency characterized by a sudden increase in intraocular pressure (IOP) due to obstruction of the pupillary aperture and iris blocking the trabecular meshwork. The condition requires prompt treatment to prevent vision loss. The management strategy for the fellow eye, which is at risk of developing angle closure, is crucial.

## **Why the Correct Answer is Right**
The correct approach for the fellow eye in a patient with angle closure glaucoma in one eye is prophylactic laser peripheral iridotomy. This procedure creates a hole in the iris, allowing aqueous humor to flow through it and bypass the blocked trabecular meshwork, thereby preventing a similar acute attack in the fellow eye. This is a preventive measure that reduces the risk of developing angle closure glaucoma in the other eye.

## **Why Each Wrong Option is Incorrect**
* **Option A:** This option might suggest a different laser treatment or no treatment, which is not the standard approach for preventing angle closure in the fellow eye.
* **Option B:** This could imply a medical treatment approach, such as using pilocarpine or other miotic agents, which might not be as effective in preventing an acute angle closure attack as a laser iridotomy.
* **Option D:** This option might suggest a surgical intervention, which is generally reserved for cases where laser treatments are not feasible or have failed.

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that once one eye has experienced an acute angle closure attack, the fellow eye has a significantly increased risk of developing a similar condition. Therefore, prophylactic laser peripheral iridotomy is often recommended for the fellow eye to prevent a similar emergency.

## **Correct Answer:** . Laser peripheral iridotomy