Acute Angle-Closure Glaucoma is a sight-threatening emergency characterized by a sudden and painful loss of vision due to the rapid closure of the eye's drainage angle. It occurs more frequently in older females of Asian descent and is associated with a family history of glaucoma. Symptoms include blurry vision, halos around lights, severe eye pain, nausea and vomiting. Treatment involves lowering high eye pressure through oral or IV medications, pupil constriction, and later performing iridectomy surgery to permanently open the eye's drainage angle.

1. Acute Angle-Closure Glaucoma

2. Introduction
 Sight threatening emergency.
 Painful loss of vision.
 Sudden and total closure of angle.

3. Risk Factors
 Occurs in predisposed eyes, frequently
bilateral.
 Age (+/- 60s)
 Gender (female > male, 4:1)
 Race (uncommon in blacks)
 Family history

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. Features of Acute Angle Closure
Glaucoma
O/E.
 Red eye.
 Hazy cornea.
 Mid dilated non reactive pupil.
 Very high IOP.

6. Acute Angle-closure Glaucoma
Note
 Corneal haze
 Mid dilated
pupil
 Red eye
 +ve eclipse
sign

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. 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