CASE REPORT

Acute angle closure glaucoma: management in acute attack setting

Krisnhaliani Wetarini , Ni Made Ratih Purnama Dewi, Ni Made Widya Mahayani

Krisnhaliani Wetarini
General Practitioner, Bhayangkara Hospital Denpasar, Bali, Indonesia. Email: krisnhaliani@yahoo.com

Ni Made Ratih Purnama Dewi
General Practitioner, Bhayangkara Hospital Denpasar, Bali, Indonesia

Ni Made Widya Mahayani
Department of Ophthalmology, Bhayangkara Hospital Denpasar, Bali, Indonesia
Online First: April 01, 2020 | Cite this Article
Wetarini, K., Dewi, N., Mahayani, N. 2020. Acute angle closure glaucoma: management in acute attack setting. Bali Medical Journal 9(1): 386-389. DOI:10.15562/bmj.v9i1.1659


Introduction: Acute angle closure glaucoma is an emergency ophthalmic condition that occurs due to a sudden closure of the angle in the anterior chamber of the eye, causing an abrupt intraocular pressure (IOP) increase. The purpose of writing this case is to present clinical findings in acute glaucoma and the initial managements taken in reducing IOP.

Case: A 45-year-old gentleman presented with 24-hour history of sudden severe left-sided headache associated with reduced vision on his left eye. Examination on the left eye revealed mixed conjunctival and ciliary injection, with visual acuity of 4/60 and raised intraocular pressure with the value of 40.2 on Schiotz tonometry. The anterior chamber was shallow, cornea was edematous, pupil was mid-dilated with diameter of 4 mm and unresponsive to light, iris crypt unclear, and hazed lens. The contralateral eye had a deep anterior chamber with normal pressure and a clear lens. He was treated initially by oral acetazolamide 250 mg two times a day, oral analgesic, a topical beta blocker 0,5% two times a day, and a topical steroid six times a day.

Conclusion: A prompt and appropriate management in cases of acute glaucoma can prevent further complications and permanent blindness.

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