The rapid increase in intraocular pressure is due to a narrowed angle and forward displacement of the iris leading to a reduction in the outflow of aqueous humor. It may also occur in someone with prolonged pupil dilation.
Unlike POAG (open-angle glaucoma), PACG has a sudden and rapid onset.
Acute angle-closure glaucoma includes a sudden and extremely painful sensation in or around the eye, which radiates over the face causing headache and brow pain.
Blurred vision is a common symptom, as well as decreased light perception.
Patients often complain of seeing colored halos around lights.
Patients may experience nausea and vomiting.
IOP readings in acute angle-closure glaucoma are typically over 30 mm Hg and may be as high as 50 mm Hg.
Drug therapy includes the use of miotics, prostaglandin agonists, IV mannitol, or glycerin liquid (Ophthalgan) in order to lower IOP.
For long term treatment and to prevent recurrent episodes, a laser peripheral iridotomy or surgical iridectomy may be indicated. This opens a new channel in the iris to allow for aqueous humor to flow through. The procedure can also be performed in the other eye as a preventative measure.
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