Acute Angle Closure Glaucoma

Question 1

What is glaucoma?

Answer 1

a group of disorders characterised by optic neuropathy due, in the majority of patients, to raised intraocular pressure (IOP)

Question 2

What is acute angle close glaucoma?

Answer 2

there is a rise in IOP secondary to an impairment of aqueous outflow

Question 3

What is acute angle close glaucoma?

Answer 3

there is a rise in IOP secondary to an impairment of aqueous outflow

Question 4

What are the predisposing factors

Answer 4

hypermetropia (long-sightedness)
pupillary dilatation
lens growth associated with age

Question 5

features

Answer 5

severe pain: may be ocular or headache

decreased visual acuity

symptoms worse with mydriasis (e.g. watching TV in a dark room)

hard, red-eye

haloes around lights

semi-dilated non-reacting pupil

corneal oedema results in dull or hazy cornea

systemic upset may be seen, such as nausea and vomiting and even abdominal pain

Question 6

Initial Mx

Answer 6

eye drops - direct parasympathomimetic e.g. pilocarpine, beta blocker e.g. timolol and alpha-2-agonist e.g. apraclonidine

IV acetazolamide

Question 7

definitive Mx

Answer 7

laser peripheral iridotomy