Acute angle-closure glaucoma

Question 1

what is glaucoma?

Answer 1

• optic neuropathy due to raised intraocular pressure (IOP)

Question 2

What happens in acute angle-closure glaucoma?

Answer 2

• rise in intraocular pressure secondary to an impairment of aqueous outflow

Question 3

Predisposing factors to AACG

Answer 3

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

Question 4

Features of AACG

Answer 4

• severe pain (ocular or headache)
• decreased visual acuity
• symptoms worse with mydriasis (watching TV in dark room)
• haloes around lights
• semi dilated non reacting pupil
• corneal edema- dull or hazy cornea

Question 5

Investigation of AACG

Answer 5

• tonometry (for increased IOP)
• Gonioscopy

Question 6

Management of AACG

Answer 6

• urgent referral to ophthalmologist
• Pilocarpine + timolol + apraclonidine
• IV acetazolamide (reduces aqueous secretion)

Question 7

Definitive treatment for AACG

Answer 7

• laser peripheral iridotomy