Acute closed-angle glaucoma
| Headline | |
|---|---|
| Etiology | Trauma, hyphaema |
| Epidemiology | |
| Clinical presentation | Sudden visual loss, N&V, frontal headache, eye pain, halos around lights (endothelial dysfunction in cornea) hazy oedematous cornea, fixed semi-dilated ovoid pupil, ciliary redness, limbal hyperaemia |
| Pathogenesis | |
| Diagnostic investigations | IOP using tonometer Ddx: |
| Management | Acutely: pilocarpine, PO/IV acetazolamide, mannitol ➥ Topical: dexamethasone, beta-blocker, alpha agonist ➥ analgesia, anti-emetic, nurse in brightly lit room, head raised, monitor IOP Definitive: peripheral iridotomy bilat else 80% risk of recurrence in other eye |
acute closed angle glaucoma vs anterior uveitis
| Acute glaucoma | Anterior uveitis | |
|---|---|---|
| Pain | ++ | ++ |
| Photophobia | - | ++ |
| Visual acuity | ↓ | ↓ |
| Cornea | N | hazy |
| Pupil | large | small |
| IOP | ↑ | N |