Glaucoma, acute and closed angle

H40.0-6/H40.8-9


DESCRIPTION

Acute closed angle glaucoma is damage to the optic nerve caused by raised intra-ocular pressure. This may result in loss of vision usually in one eye.

Clinical features:

  • pupil is moderately dilated and may be oval in shape
  • corneal haziness
  • pericorneal conjunctival inflammation
  • sudden onset of extremely severe, bursting pain and eye redness
  • a unilateral, temporal headache, after being exposed to a period of darkness, e.g. in a cinema
  • coloured haloes around lights (bright rings)
  • eye feels hard, compared to the other eye, when measured with finger palpation (this is not an accurate test)
  • severe pain in eye (acute)
  • nausea and vomiting in severe cases

Note: The more common chronic open angle glaucoma is usually without symptoms.

Emergency medicine treatment before referral (Doctor prescribed)

  • Acetazolamide, oral, 500 mg, immediately, followed by 250 mg 6 hourly until referred.

REFERRAL

Urgent

All patients to an ophthalmologist within 12 hours.