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Acute glaucoma

Rare cause of painful red eye but early diagnosis important to prevent severe visual loss.

Presentation:

  • Severely  painful red eye. 
  • Haloes around light common. 
  • Patients usually over 50 years old. 
  • Nausea and vomiting common
    • Examination:
    • Reduced visual acuity.
    • Hazy cornea and the iris is not clearly visible. 
    • Pupil is fixed or semi-dilated, unreactive to light
    Management:
    • Urgent referrals ie as soon as possible and not the next day.
    • Patient is usually admitted and given acetazolamide IV to lower pressure. 

      • Topical pilocarpine and steroid (to reduce inflammation) are also given.

     
    Figure 1
    Eye of a patient with acute angle closure glaucoma. Note the hazy cornea with 
    semi-dilated and distorted pupil which are the common signs in this condition. In 
    addition, digital palpation usually reveals that the affected eye is firmer than the 
    unaffected eye due to the high intraocular pressure.

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