Glaucoma, Acute and Closed Angle

Description

Referral

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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.

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Note:

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

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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.

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_30 September 2024

Chapter 18: Eye Conditions_18.4 Glaucoma, Acute and Closed Angle