Acute Angle-Closure Glaucoma

Key points

• Ophthalmic emergency: sudden painful red eye · reduced vision with haloes around lights · fixed semi-dilated oval pupil · corneal oedema · hard eye (raised IOP).
• Precipitated by pupil dilation (dim light, anticholinergics) in anatomically narrow angles; hypermetropes at risk.
• Immediate management: lie patient supine; IV/oral acetazolamide + topical pilocarpine, beta-blocker, steroid, apraclonidine.
• Definitive: laser peripheral iridotomy (both eyes) once attack controlled.
• Urgent same-day ophthalmology referral required.

Decision points in this pathway

• Attack controlled?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.