Acute Angle-Closure Glaucoma

Ophthalmology

Sudden rise in IOP from blockage of aqueous outflow — sight-threatening.

Clinical features

  • Severe eye pain, headache, nausea, vomiting
  • Blurred vision, haloes around lights

Examination

  • Red eye, cloudy cornea
  • Fixed mid-dilated pupil
  • Rock-hard eyeball

Management

  • Lie supine; urgent ophthalmology
  • Topical: timolol 0.5%, pilocarpine 2%, apraclonidine
  • Oral acetazolamide 500 mg + IV if vomiting
  • Mannitol 1 g/kg IV if refractory
  • Definitive: laser peripheral iridotomy

References

  • RCOphth Glaucoma 2022

Educational — verify locally.

WardRound

WardRound

Clinical Decisions in Seconds