Acute angle-closure glaucoma

June 5, 2023/

Acute angle-closure glaucoma is a medical emergency that requires prompt diagnosis and treatment to prevent vision loss. Here are some important points to keep in mind about the presentation and treatment of acute angle-closure glaucoma:

Presentation:

  • Acute angle-closure glaucoma is typically characterized by sudden onset of severe eye pain, headache, and vision loss.
  • Other signs and symptoms may include a mid-dilated pupil that is unresponsive to light, microcytic corneal edema, and a shallow anterior chamber and iris bombe.

Treatment:

  • The primary treatment for acute angle-closure glaucoma is to lower intraocular pressure (IOP) as quickly as possible.
  • Initial treatment may involve topical and/or systemic medications, such as beta blockers and carbonic anhydrase inhibitors, to decrease aqueous humor production and lower IOP.
  • Pilocarpine, a miotic agent that constricts the pupil and opens the angle, should be avoided in acute angle-closure glaucoma.
  • A laser peripheral iridotomy (LPI) is typically performed as soon as possible to relieve the angle closure and prevent future attacks.
  • In cases where LPI is not feasible, surgical iridectomy or trabeculectomy may be necessary to reduce IOP and prevent further vision loss.

In conclusion, acute angle-closure glaucoma is a medical emergency that requires prompt diagnosis and treatment to prevent vision loss. Characteristic signs and symptoms include sudden onset of severe eye pain, headache, vision loss, and a mid-dilated pupil. Treatment involves lowering IOP as quickly as possible with topical and/or systemic medications, avoiding pilocarpine, and performing a LPI as soon as possible. In cases where LPI is not feasible, surgical intervention may be necessary to prevent further vision loss.