ICD-10: H21.55

The ICD-10 code H21.55 pertains to the condition known as "Recession of chamber angle," which is a specific diagnosis related to the anatomy of the eye. This condition is categorized under the broader classification of disorders affecting the anterior segment of the eye, particularly concerning the angle formed between the cornea and the iris, which is crucial for the drainage of aqueous humor.

Clinical Description

Definition

Recession of the chamber angle refers to a situation where the angle between the cornea and the iris is abnormally positioned or altered, potentially leading to issues with intraocular pressure and drainage of fluid from the eye. This condition can be associated with various forms of glaucoma, where the drainage of aqueous humor is impaired, resulting in increased intraocular pressure.

Types

The ICD-10 code H21.55 is further specified into two subcategories:
- H21.551: Recession of chamber angle, right eye
- H21.559: Recession of chamber angle, unspecified eye

These distinctions are important for clinical documentation and treatment planning, as they indicate whether the condition affects one eye specifically or is not specified for either eye.

Clinical Implications

Symptoms

Patients with recession of the chamber angle may experience symptoms related to increased intraocular pressure, which can include:
- Blurred vision
- Eye pain
- Headaches
- Halos around lights
- Nausea or vomiting in severe cases

Diagnosis

Diagnosis typically involves a comprehensive eye examination, including:
- Visual field testing: To assess peripheral vision loss, which can indicate glaucoma.
- Gonioscopy: A specialized examination that allows the clinician to visualize the chamber angle directly and assess its structure and function.
- Tonometry: To measure intraocular pressure.

Treatment

Management of recession of the chamber angle often focuses on controlling intraocular pressure and may include:
- Medications: Such as topical prostaglandins, beta-blockers, or carbonic anhydrase inhibitors to reduce fluid production or increase drainage.
- Surgical interventions: In cases where medical management is insufficient, procedures such as trabeculectomy or laser therapy may be considered to improve drainage.

Conclusion

The ICD-10 code H21.55 for recession of chamber angle is a critical classification for understanding and managing conditions related to intraocular pressure and glaucoma. Proper diagnosis and treatment are essential to prevent potential vision loss associated with this condition. Clinicians must document the specific eye affected to ensure appropriate care and follow-up.

ICD-10 code H21.55 refers to "Recession of chamber angle," a condition that involves the anatomical changes in the anterior chamber of the eye, specifically the angle where the iris meets the cornea. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation

Definition and Pathophysiology

Recession of the chamber angle is characterized by a posterior displacement of the iris, which can lead to a narrowing or closure of the angle. This condition may be associated with various ocular diseases, including glaucoma, and can result in increased intraocular pressure (IOP) if not managed appropriately.

Common Patient Characteristics

Patients who may present with recession of the chamber angle often share certain characteristics:
- Age: This condition is more prevalent in older adults, particularly those over 60 years of age, due to age-related anatomical changes in the eye.
- Gender: There may be a slight female predominance in cases of angle recession, although this can vary based on underlying conditions.
- Ethnicity: Certain ethnic groups, particularly those of Asian descent, may have a higher incidence of angle closure and related conditions.

Signs and Symptoms

Symptoms

Patients with recession of the chamber angle may experience a range of symptoms, which can vary in severity:
- Visual Disturbances: Patients may report blurred vision or halos around lights, particularly in low-light conditions.
- Eye Pain: Discomfort or pain in the eye can occur, especially if there is associated intraocular pressure elevation.
- Headaches: Some patients may experience headaches, which can be attributed to increased ocular pressure.
- Nausea and Vomiting: In acute cases, particularly if there is a sudden rise in IOP, patients may experience systemic symptoms such as nausea.

Signs

During a comprehensive eye examination, several signs may indicate recession of the chamber angle:
- Gonioscopic Findings: Gonioscopy is essential for assessing the angle. A recession may be observed as a widening of the angle or a posteriorly positioned iris.
- Intraocular Pressure Measurement: Elevated IOP may be detected, indicating potential glaucoma.
- Pupil Reaction: The pupil may be mid-dilated and non-reactive in cases of acute angle closure.

Conclusion

Recession of the chamber angle (ICD-10 code H21.55) is a significant ocular condition that can lead to serious complications if not addressed. Understanding the clinical presentation, including the common signs and symptoms, as well as the characteristics of affected patients, is vital for healthcare providers. Early detection through thorough examination and appropriate management can help mitigate the risks associated with this condition, particularly the development of glaucoma and vision loss. Regular eye examinations are recommended, especially for individuals at higher risk due to age or ethnicity.

The ICD-10 code H21.55 refers specifically to the "Recession of chamber angle" in the right eye. This condition is categorized under the broader classification of disorders affecting the iris and ciliary body. Below are alternative names and related terms that may be associated with this diagnosis:

Alternative Names

1. Angle Recession: This term is commonly used in ophthalmology to describe the condition where the angle of the anterior chamber of the eye is displaced or receded, often due to trauma.
2. Recessed Anterior Chamber Angle: This phrase describes the anatomical change in the eye's structure, indicating a backward displacement of the chamber angle.
3. Ciliary Body Recession: While this term is more general, it can refer to changes in the ciliary body that may accompany recession of the chamber angle.

Related Terms

1. Glaucoma: Although not synonymous, angle recession can lead to secondary glaucoma, a condition characterized by increased intraocular pressure.
2. Traumatic Angle Recession: This term specifically refers to angle recession resulting from ocular trauma, which is a common cause of this condition.
3. Anterior Chamber: This is the space in the eye between the cornea and the iris, where the recession occurs.
4. Iris and Ciliary Body Disorders: This broader category includes various conditions affecting the iris and ciliary body, under which H21.55 is classified.

Clinical Context

Understanding these terms is crucial for healthcare professionals when diagnosing and coding conditions related to the eye. Accurate terminology helps in effective communication among medical practitioners and ensures proper billing and coding practices.

In summary, while H21.55 specifically denotes "Recession of chamber angle," it is important to recognize the alternative names and related terms that provide context and clarity regarding this condition.

The ICD-10 code H21.55 refers to "Recession of chamber angle," which is a condition related to the anatomy of the eye, specifically the angle formed between the cornea and the iris. This condition can have implications for intraocular pressure and may be associated with various forms of glaucoma.

Diagnostic Criteria for H21.55

Diagnosing recession of the chamber angle typically involves a combination of clinical evaluation and specific diagnostic tests. Here are the key criteria and methods used in the diagnosis:

1. Clinical Examination

• Patient History: A thorough history is taken to identify symptoms such as visual disturbances, eye pain, or a family history of glaucoma.
• Visual Acuity Testing: Assessing the clarity of vision can help rule out other conditions.

2. Slit-Lamp Examination

• This examination allows the ophthalmologist to visualize the anterior segment of the eye, including the cornea, iris, and chamber angle. The angle can be assessed for recession or other abnormalities.

3. Gonioscopy

• Definition: Gonioscopy is a specialized procedure that uses a goniolens to view the anterior chamber angle directly.
• Purpose: It helps determine the structure and width of the angle, identifying any recession or closure that may indicate glaucoma risk.

4. Intraocular Pressure Measurement

• Elevated intraocular pressure (IOP) can be a sign of angle recession, particularly if it is associated with other findings of glaucoma.

5. Visual Field Testing

• This test assesses peripheral vision and can help identify any functional loss associated with glaucoma, which may be secondary to angle recession.

6. Imaging Techniques

• Optical Coherence Tomography (OCT): This imaging technique can provide detailed cross-sectional images of the eye, helping to assess the angle and any structural changes.
• Ultrasound Biomicroscopy: This may be used to visualize the anterior segment in more detail, particularly in complex cases.

Conclusion

The diagnosis of recession of the chamber angle (ICD-10 code H21.55) is multifaceted, relying on a combination of patient history, clinical examination, and specialized diagnostic tests. Gonioscopy is particularly crucial for directly assessing the angle's anatomy, while imaging techniques can provide additional insights into the structural changes associated with this condition. Proper diagnosis is essential for determining the appropriate management and treatment options, especially in the context of glaucoma risk.

The ICD-10 code H21.55 refers to "Recession of chamber angle," a condition that can be associated with various forms of glaucoma and other ocular issues. Treatment approaches for this condition typically focus on managing intraocular pressure (IOP) and preventing further damage to the optic nerve. Below, we explore standard treatment strategies for this diagnosis.

Understanding Recession of Chamber Angle

Recession of the chamber angle indicates a structural change in the eye where the angle between the cornea and the iris is altered, potentially leading to impaired aqueous humor drainage. This can result in increased intraocular pressure, which is a significant risk factor for glaucoma.

Standard Treatment Approaches

1. Medications

• Topical Medications: The first line of treatment often involves the use of topical medications to lower IOP. Common classes of medications include:
• Prostaglandin analogs (e.g., latanoprost, bimatoprost) that increase aqueous humor outflow.
• Beta-blockers (e.g., timolol) that reduce aqueous humor production.
• Alpha agonists (e.g., brimonidine) that both decrease production and increase outflow.

• Carbonic anhydrase inhibitors (e.g., dorzolamide) that reduce aqueous humor production.

• Oral Medications: In some cases, oral carbonic anhydrase inhibitors (e.g., acetazolamide) may be prescribed for more significant IOP reduction, especially in acute situations.

2. Laser Treatments

• Laser Peripheral Iridotomy (LPI): This procedure creates a small hole in the peripheral iris to improve aqueous humor flow and relieve pressure in the anterior chamber. It is particularly useful in cases where angle closure is a concern.

• Laser Trabeculoplasty: This treatment enhances the drainage of aqueous humor through the trabecular meshwork, thereby lowering IOP. It can be performed as an initial treatment or when medications are insufficient.

3. Surgical Interventions

• Trabeculectomy: This surgical procedure creates a new drainage pathway for aqueous humor, effectively lowering IOP. It is typically considered when medical and laser treatments fail to control pressure adequately.

• Tube Shunt Surgery: In cases where trabeculectomy is not suitable, a tube shunt may be implanted to facilitate aqueous humor drainage.

4. Monitoring and Follow-Up

Regular monitoring of IOP and visual field testing is crucial for patients diagnosed with recession of the chamber angle. This helps in assessing the effectiveness of the treatment and making necessary adjustments.

5. Patient Education

Educating patients about their condition, the importance of adherence to prescribed treatments, and recognizing symptoms of increased IOP (such as headaches, blurred vision, or eye pain) is essential for effective management.

Conclusion

The management of recession of chamber angle, as indicated by ICD-10 code H21.55, involves a combination of pharmacological, laser, and surgical interventions tailored to the individual patient's needs. Regular follow-up and patient education play critical roles in ensuring optimal outcomes and preventing progression to more severe forms of glaucoma. As always, treatment plans should be developed in consultation with an ophthalmologist, who can provide personalized recommendations based on the patient's specific condition and overall health.