acute glaucoma

Acute glaucoma is when the pressure inside the eye goes up suddenly.  This usually occurs because of a sudden closure of the drainage “angle” inside the eye.  With no drainage, the aqueous humor fluid builds up and causes a spike in eye pressure that can lead to rapid vision loss.  Symptoms include extreme eye pain along with nausea and halos seen around lights. Treatment is geared toward lowering the pressure and “breaking the attack,” often with a laser, eye drops, and diuretic pills like Diamox.  Acute glaucoma is less common in the USA as most people with glaucoma have chronic “open-angle” glaucoma.  If an eye appears to be at risk for having an attack, then we will sometimes perform a prophylactic laser procedure called a laser peripheral iridotomy (LPI) to decrease the likelihood of this problem.

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Dr. Timothy Root is a practicing ophthalmologist and cataract surgeon in Daytona Beach, Florida. His books, video lectures, and training resources can be found at:

2 COMMENTS

  1. Acute glaucoma is a real emergency, and the presentation can be pretty dramatic … most of the patients I’ve seen with this condition have come into my office with extreme eye pain. Often they are throwing up into the waste basket.

    To treat these, I attempt to perform a LPI laser procedure. Unfortunately, the cornea is pretty steamy, and the iris is plastered up against the back of the cornea, making it hard to get good laser uptake. In these cases, I often need to perform a surgical iridectomy in the operating room.

  2. First line of treatment to lower the iop by whatever means available, iv manitol. acetozolamide , pilocarpine etc, once stable one can go for laser pbi.

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