angle closure glaucoma

Question 1

presenting sx

Answer 1

Acute angle closure glaucoma presents as an acutely painful red eye with an associated raised
intraocular pressure. This constitutes an ophthalmic emergency and should be diagnosed
promptly, as timely treatment saves permanent blindness from irreversible damage to the optic
nerve. It also constitutes as an important differential for exams for headache with nausea and
vomiting.

Question 2

signs on examination of the eye

Answer 2

Fixed oval shaped mid-dilated pupil not responsive to light
§ Much reduced vision
§ Cloudy cornea
§ Extreme pain
§ Hyperaemia of conjunctiva
§ Associated nausea and vomiting

Question 3

important features of history to ask

Answer 3

It is imperative that examining clinicians identify clinical features and associated risk factors by
asking a detailed history including long-sightedness, advanced age, use of cough syrup, or
ocular surgery.

Question 4

mx

Answer 4

Treatment involves intravenous (or oral) administration of acetazolamide to reduce the
intraocular pressure, alongside topical steroids and intraocular pressure lowering eye drops
(such as latanoprost or timolol).