Feature Article

Recognition and management of acute glaucoma

Karin Attebo, Minas T Coroneo

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Abstract

Acute glaucoma is a medical emergency that often occurs in the evening when the GP is the first port of call. Early assessment, initiation of treatment and appropriate referral will maximise the amount of vision saved.

Key Points

  • Acute angle closure glaucoma is a medical emergency that requires immediate referral to an ophthalmologist.
  • During a subacute glaucoma attack, patients may see rainbow-coloured haloes around lights and have some mistiness of vision and eye discomfort. These symptoms always warrant referral to an ophthalmologist.
  • Acute glaucoma causes sudden profound reduction of vision, severe pain in and around the eye and often nausea and vomiting. Cardinal signs include a red eye, with a mid-dilated, fixed ovoid pupil and a cloudy cornea.
  • The differential diagnoses are those of ‘the acute red eye’, which include iritis, conjunctivitis, keratitis and episcleritis.
  • Acute glaucoma may be prevented by laser peripheral iridotomy.

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