Acute Angle Closure Glaucoma

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Acute Angle Closure Glaucoma - Dr James Beatty

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Acute Angle Closure Glaucoma

  1. 1. Acute Angle-Closure Glaucoma
  2. 2. Introduction  Sight threatening emergency.  Painful loss of vision.  Sudden and total closure of angle.
  3. 3. Risk Factors  Occurs in predisposed eyes, frequently bilateral.  Age (+/- 60s)  Gender (female > male, 4:1)  Race (uncommon in blacks)  Family history
  4. 4. Features of Acute Angle Closure Glaucoma  History of transient blurring and haloes (t.v,dark room, sewing, reading)  Rapidly progressive unilateral visual loss  Severe aching orbital pain with nausea & vomiting
  5. 5. Features of Acute Angle Closure Glaucoma O/E.  Red eye.  Hazy cornea.  Mid dilated non reactive pupil.  Very high IOP.
  6. 6. Acute Angle-closure Glaucoma Note  Corneal haze  Mid dilated pupil  Red eye  +ve eclipse sign
  7. 7. Treatment of Acute Angle-closure Glaucoma  Give anti emetic PRN  All clinics should have aqueous suppressants: Diamox (give 500mg po +/- 500mg IVI) Betagan drops (give one)  Refer patient immediately
  8. 8. Treatment of Acute Angle-closure Glaucoma  We will give glycerol 1ml/kg po or Mannitol IV to dehydrate the eye osmotically  Pilocarpine is used to constrict the pupil once the pressure has come down  Topical steroids (dexamethasone QID)  A peripheral Iridectomy/otomy is done when the cornea clears

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