Professional Documents
Culture Documents
Teeranun
Puttala
I201020056 MBBS2010
Ophthalmology
1. Stages and treatments of Acute Angle Closure
Glaucoma (AACG)
Acute Angle Closure Glaucoma is a true ophthalmic
emergency and appropriate therapy must be instituted immediately
to prevent vision loss. It is caused by a rapid or sudden increase in
pressure inside the eye or intraocular pressure (IOP). This typically
happens when the iris is pushed against the trabecular meshwork
(the spongy tissue located near the cornea where the aqueous
humor flows out of the eye) or drainage channels, and the fluid or
aqueous humor (the watery fluid that nourishes the interior of our
eye) that normally drains out of the eye is blocked. This creates the
increase in IOP.
Patients have severe ocular pain and redness, decreased
vision, colored halos around lights, headache, nausea, and vomiting.
The systemic complaints may be so severe that patients are
misdiagnosed as having a neurologic or GI problem. Examination
typically reveals conjunctival hyperemia, a hazy cornea, a fixed mid-
dilated pupil, and anterior chamber inflammation. Vision is
decreased. IOP is usually 40 to 80 mm Hg. The optic nerve is difficult
to visualize because of corneal edema, and visual field testing is not
done because of discomfort.
Stages and treatments of Acute Angle Closure Glaucoma
Acute angle-closure glaucoma is divided into 6 stages
1. Pre-Clinical stage
No any symptoms
Intraocular pressure is normal
Shallow anterior chamber
Narrow angle
2. Prodromal stage
transient attack of raised tension due to cornea edema
transient blurring of vision
rainbow haloes around light
mild eye pain, mild headache
eye looks white, cornea is hazy due to edema
3. Acute congestive stage
in acute congestive stage both eyes are effect kanski
clinical ophthalmology 7th edition free download
sudden increase in IOP
sudden loss of vision
severe eye pain, severe headache, nausea and vomiting
lacrimation occur
1
Miss. Teeranun
Puttala
I201020056 MBBS2010
4. Intermittent stage
Intraocular pressure returned to normal
The disease can get temporary relief
Local congestion disappear
Transparent cornea recovered
Vision partially or fully restored
Anterior chamber reopened
5. Chronic stage
chronically elevated IOP
gonioscopically confirmed peripheral anterior synechiae
(PAS) of more than 180
glaucomatous cupping are seen
optic nerve head and visual field changes, with or without
prior symptoms
visual field defects
diminishing in vision,
6. Absolute stage
Uncontrolled in IOP
IOP is high and eyeball becomes stony hard.
The eye is painful irritable and completely blind.
The anterior ciliary veins are dilated with a light ciliary
flush around the cornea.
Cornea becomes hazy
Cornea Bollous karatitis are seen
Iris shows white patches dilatation of pupil occur
Fundoscopy reveals glaucomatous optic atrophy
Treatments of Acute Angle Closure Glaucoma
The goal of treatment is to reduce intraocular pressure as soon
as possible.
1. Medical treatment: To lower the pressure within the eye.
Eye drop
Timolol : Beta-blockers - to reduce intraocular pressure by
slowing down the production of aqueous humour in the eye
2
Miss. Teeranun
Puttala
I201020056 MBBS2010
3
Miss. Teeranun
Puttala
I201020056 MBBS2010
4
Miss. Teeranun
Puttala
I201020056 MBBS2010
Summary
5
Miss. Teeranun
Puttala
I201020056 MBBS2010