Acute Angle Closure Glaucoma - Dr James Beatty

1. Acute Angle-Closure Glaucoma

2. Introduction
 Sight threatening emergency.
 Painful loss of vision.
 Sudden and total closure of angle.

3. Risk Factors
 Occurs in predisposed eyes, frequently
bilateral.
 Age (+/- 60s)
 Gender (female > male, 4:1)
 Race (uncommon in blacks)
 Family history

4. Features of Acute Angle Closure
Glaucoma
 History of transient blurring and haloes
(t.v,dark room, sewing, reading)
 Rapidly progressive unilateral visual loss
 Severe aching orbital pain with nausea &
vomiting

5. Features of Acute Angle Closure
Glaucoma
O/E.
 Red eye.
 Hazy cornea.
 Mid dilated non reactive pupil.
 Very high IOP.

6. Acute Angle-closure Glaucoma
Note
 Corneal haze
 Mid dilated
pupil
 Red eye
 +ve eclipse
sign

7. Treatment of Acute Angle-closure
Glaucoma
 Give anti emetic PRN
 All clinics should have aqueous suppressants:
Diamox (give 500mg po +/- 500mg IVI)
Betagan drops (give one)
 Refer patient immediately

8. Treatment of Acute Angle-closure
Glaucoma
 We will give glycerol 1ml/kg po or Mannitol IV
to dehydrate the eye osmotically
 Pilocarpine is used to constrict the pupil once
the pressure has come down
 Topical steroids (dexamethasone QID)
 A peripheral Iridectomy/otomy is done when
the cornea clears