A 72-year-old has acute angle-closure glaucoma with corneal oedema, fixed mid-dilated pupil and intraocular pressure 55 mmHg. Which initial plan is

Question

A 72-year-old has acute angle-closure glaucoma with corneal oedema, fixed mid-dilated pupil and intraocular pressure 55 mmHg. Which initial plan is appropriate?

Accepted Answer

Begin acetazolamide and topical pressure-lowering treatment, then perform laser iridotomy once feasible

Answer

Patch the eye and avoid systemic treatment because pressure will fall during sleep

Answer

Dilate the pupil with atropine because cycloplegia opens the drainage angle

Answer

Use topical corticosteroid alone and review after one week

Answer

Perform cataract surgery months later before completing first treating the acute pressure crisis

Acute Angle-Closure Glaucoma — RACP Adult Medicine MCQ

A 72-year-old has acute angle-closure glaucoma with corneal oedema, fixed mid-dilated pupil and intraocular pressure 55 mmHg. Which initial plan is appropriate?