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DR Medhat MRCP

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Acute angle closure glaucoma<br />

- In acute angle closure glaucoma (AACG) there is a rise in IOP secondary to an impairment<br />

of aqueous outflow.<br />

• Predisposing factors :<br />

• Features :<br />

1) Hypermetropia (long-sightedness)<br />

2) Pupillary dilatation<br />

3) Lens growth associated with age<br />

Severe pain: may be ocular or headache<br />

Decreased visual acuity<br />

Symptoms worse with mydriasis (e.g. watching TV in a dark room)<br />

Hard, red eye<br />

Haloes around lights<br />

Semi-dilated non-reacting pupil<br />

Corneal oedema results in dull or hazy cornea<br />

Systemic upset may be seen, such as nausea and vomiting and even abdominal<br />

pain<br />

• Management<br />

Urgent referral to an ophthalmologist<br />

Acetazolamide ( reducing aqueous secretions) + Topical Pilocarpine ( induces miosis).<br />

NB : Important <strong>MRCP</strong> questions<br />

Open angle glaucoma- myopia<br />

Acute angle closure glaucoma- hypermetropia.<br />

TTT of closed angle glaucoma : Acetazolamide + Topical Pilocarpine<br />

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