Sunday, February 12, 2017

Acute angle closure Glaucoma

emDocs - February 10, 2017 - Authors: Langridge C and Williams D
Edited by: Koyfman A and Long B

  • Consider AACG in all patients presenting with headache and visual changes, especially if associated with nausea and vomiting.
  • AACG occurs more frequently in females and those of Asian descent.
  • Early and effective therapy is vital in reducing optic nerve ischemia and vision loss. Time is optic nerve.
  • Be aware of the patient’s comorbidities and allergies before treating (i.e. be aware of the risks of topical β blockers in COPD/asthma, sulfa allergy with acetazolamide use)
  • Consider corneal indentation as a temporizing maneuver if IOP is not satisfactorily lowered in a reasonable amount of time.
  • There is no emergent treatment that an ophthalmologist can offer that an emergency physician cannot. Definitive treatment is with LPI, however this is frequently delayed until corneal clearing occurs. Thus topical and IV agents are paramount in early treatment of AACG."