acute Angle closure glaucoma

Question 1

define Angle closure glaucoma

Answer 1

acute Angle closure glaucoma
-there is a rise in IOP secondary to an impairment of aqueous outflow

the iris bulges forward and seals off the trabeuclar meshword from the anterior chamber preventing aqueous humour from being able to drain away

Question 2

where does build up of aqueous humour in Angle closure glaucoma occur

Answer 2

particularly in the posterior chamber

which causes pressure behind the iris and worsesn the closure of the angle

Question 3

what is important to note for acute Angle closure glaucoma

Answer 3

it is an ophthalmology emergency

-treatment is required to prevent permanent loss of vision

Question 4

risk factors for acute Angle closure glaucoma 5

Answer 4

incresing age

females are affected. 4x more than men

FHx

chine and eat asian (rare in black people)

shallow anterior chamber

Question 5

what medications can precipitate acute Angle closure glaucoma 3

Answer 5

adrenergic medications- such as noradrenalin

anticholinergic medications
-such as oxybutynin and solifenacin

tricyclic antidepressants
-such as amitriptyline (which have anticholinergic effects)

Question 6

syx of acute Angle closure glaucoma 4

Answer 6

appear generally unwell in themselves

short Hx of:
-severely painful red eye
-blurred vision
-halos around lights
-assoc headache, N+V

Question 7

examination of acute Angle closure glaucoma 7

Answer 7

semi-dilated non-reacting pupils

teary

red eye

decreased visual acuity

dilatation of affected pupil

pupil fixed size

firm eyeball on palpation

Question 8

inital management of acute Angle closure glaucoma 4

Answer 8

lie patient on back without a pillow

give pilocarpine eye drops

give acetazolamide 500mg orally

give analgesic and antiemetic if required

Question 9

definitve managemetnr of acute Angle closure glaucoma

Answer 9

laser peripheral iridotomy

creates a tiny hole in the peripheral iris
-aqueous humour flowing to the angle