angle closure glaucoma
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Acute Angle Closure GlaucomaAn abrupt block in the fluid circulation in the eye, resulting in increased intraocular/anterior chamber pressure and potential damage of the optic nerve and blindness which occurs when the intensity of iris bombé is sufficient to occlude the anterior chamber angle (ACA). AACG is more common in patients with preexisting narrowing of the ACA, which occurs in hypermetropes.
Clinical findings Sudden onset of blurred vision, severe ocular or facial pain, visual halos, nausea, vomiting, increased intraocular pressure, shallow anterior chamber, steamy cornea, fixed—nonreactive—dilated pupil, ciliary injection.
Management IV/oral acetazolamide, topical beta blockers, hyperosmotic agents, pilocarpine or reduce intraocular pressure; after intraocular pressure is decreased, peripheral iridectomy to establish a permanent communication between anterior and posterior chambers; if there is no response to medical management, emergency trabeculectomy, laser sclerostomy.