Angle Closure Glaucoma

Acute elevations in IOP can occur when the outflow of aqueous humor is suddenly blocked. The condition is more common in Asians but may occur in any patient. An acute angle-closure attack may follow an episode of emotional or physical stress, dilation of the pupil in dim lighting, or rarely, after instillation of dilating eyedrops. A patient having an acute attack usually has severe ocular pain, redness, blurred vision, rainbow-colored halos around lights, and sometimes nausea and vomiting. On examination, the eye is usually red, pupil mid-dilated and poorly reactive, and IOP greatly elevated. Generally, only one eye is affected at a time. Corneal clouding or corneal edema may be present in advanced cases.

An acute episode of angle-closure glaucoma is an ocular emergency and requires immediate treatment to lower IOP by medical treatment. Once IOP is under control, yttrium-argongarnet (YAG) or argon laser peripheral iridectomy is performed.

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