Ophthalmology 2 - Acute Angle Closure Glaucoma

Question 1

define acute angle closure glaucoma

Answer 1

iris bulges forward and seals off trabecular meshwork

increases posterior chamber which worsens the iris bulging + closure

emergency!

Question 2

risk factor for acute angle closure glaucoma

Answer 2

old
female
FH
certain medications (norad, oxybutynin / solifenacin (antichol), amitriptyline)

Question 3

presentation of acute angle closure glaucoma

Answer 3

severely painful red eye
blurred vision
halo around lights
headache, nausea, vomiting

Question 4

examination findings acute angle closure glaucoma

Answer 4

red eye, teary
hazy cornea
reduced acuity
dilation of pupil 
fixed pupil 
firm eyeball

Question 5

management of acute angle closure glaucoma

Answer 5

lie patient on back without pillow
give pilocarpine eye drops (more if darker eyes)
give 500mg acetazolamide
analgesia, antiemetic

Question 6

what is pilocarpine?

Answer 6

a miotic agent
muscarinic antagonist
allows more flow of humour

Question 7

definitive treatment for acute angle closure glaucoma

Answer 7

laser iridotomy

hole between anterior and posterior chamber