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Dealing with Acute Glaucoma

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Two weeks ago we talked about chronic open angle glaucoma, where the patient slowly and progressively loses their bilateral vision.

Today we will concentrate on open- angle glaucoma where there is sudden loss of vision in one eye with an acute medical profile that obliges us to see an ophthalmologist or Accident and Emergency (A&E) Department immediately.{{more}}

We also mentioned that in the anterior chamber of our eyes there is a transparent liquid called aqueous humor which is responsible for the eyes nutrition, and that there should exist a balance between its production and evacuation so that there may

Be normal intra-ocular pressure. In the patient presenting acute glaucoma there is an anatomic problem whereby this equilibrium is broken on account of the patient having an eye size smaller that usual (hyperopia) with the lens or crystalline structures forward resulting in a pupillary block and so preventing aqueous humor drainage which continues it normal production provoking an excessive increase in the intra-ocular pressure.

Why does the patient come to us? Usually there is intense pain in the affected eye, headaches, nausea and vomiting and total loss of vision in the same.

What do we find on examining the patient? The eyelid commonly is swollen with the affected eye extremely red; there is loss of shine of the cornea due to existing edema with narrowing of the anterior chamber and of course there is a very high intra-ocular pressure that can reach to infinity producing optic nerve damage resulting in blindness.

What are the risk factors in the developing this kind of glaucoma? Generally, it is most frequent in persons over 65 years old, patients with hyperopia, family history of acute glaucoma and the use of dilating eye drops (example – atropine).

How is acute glaucoma treated? Initial treatment is urgent in a hospital with analgesics (painkillers), medication for the vomiting and immediate attention to try and decrease the intra-ocular pressure bringing it to normal values with pilocarpine (eye drops), mannitol and azetozolamide.

Once the acute attack is controlled, the patient must have surgical intervention with laser or conventional surgery in the affected eye and after in the other eye to prevent the same occurring there.

My advice to you my fellow reader is to never use eye drops without being prescribed by your ophthalmologists and to assist immediately to your doctor if you are suffering from severe eye pain, loss of and / nauseas and vomiting.

l What do you know about dry eyes? This will be our next topic.