Closed (acute) angle glaucoma

Question 1

What causes acute angle glaucome?

Answer 1

obstruction of the trabecular meshwork by the iris stops drainage of aqueous humour in the anterior chamber of the eye

Question 2

What is the typical age at which angle closure glaucoma presents?

Answer 2

• 6th and 7th decade

occurs in 1/1000 of over 40yrs

Question 3

What are the symptoms of angle closure glaucoma?

Answer 3

• pain (rapidly progressive, can spread around the orbit)
• blurred vision (rapid progression to vision loss)
• coloured haloes around lights
• systemic malaise
• nausea / vomiting

Question 4

What are the signs of angle closure glaucoma?

Answer 4

• Red eye (ciliary flush more around periphery of cornea)
• palpation of the globe will be hard
• raised intra-ocular pressure
• usually unilateral attack

Question 5

What are the differential diagnosis for angle closure glaucome?

Answer 5

• traumatic glaucoma
• corneal disorder
• anterior uveitis
• optic neuritis

Question 6

What invx are done for angle closure glaucoma?

Answer 6

Diagnosis made on 2 symptoms + 3 signs:
sympt:
- nausea/vom
- ocular pain
- intermittent blurring of vision with halos.

signs:

• raised IOP
• conjunctival injection
• corneal, epithelial oedema
• mild dilated non-reactive pupil
• shallow chambers

Question 7

what are the complications of acute angle closure glaucoma?

Answer 7

• permanent vision loss

Question 8

What is the treatment of closed angle glaucoma?

Answer 8

EYE EMERGENCY:
1) topical glaucoma medication e.g.
beta blockers e.g. timolol
steroids e.g. prednisolone
Phenylephrine

2) IV acetazolamide
3) Laser