Acute angle-closure glaucoma — MCCQE Part 1 MCQ

Correct answer: C — Start intraocular-pressure-lowering treatment and obtain urgent ophthalmology consultation

Start intraocular-pressure-lowering treatment and obtain urgent ophthalmology consultation is the single best answer because the age, timing, examination findings and investigations in the vignette fit Acute angle-closure glaucoma better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Ophthalmological Society guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Ophthalmological Society guidance