Acute Angle Closure Glaucoma

Question 1

What is acute angle closure glaucoma?

Answer 1

A rise in IOP secondary to an impairment of aqueous outflow

Question 2

What factors predispose you to a use angle closure glaucoma?

Answer 2

Hypermetropia (longsightedness)
Pupillary dilatation
Lens growth associated with age

Question 3

What are the presenting features of acute angle closure glaucoma?

Answer 3

Severe pain (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

Question 4

How do you manage acute angle closure glaucoma?

Answer 4

Urgent referral to ophthalmologist

Reduce aqueous secretions with acetazolamide and inducing pupillary constriction with topical pilocarpine

Question 5

Which of the following would NOT support the diagnosis of acute angle closure glaucoma?

Vomiting
Haloes around lights
Dull cornea
Small phill
Decreased visual acuity

Answer 5

Small pupil

In acute angle closure glaucoma the pupil is semi dilated

Question 6

Acute angle closure glaucoma is associated with myopia or hypermetropia?

Answer 6

Hypermetropia