A 39-year-old woman presents with painful red eye, blurred vision and haloes around lights. She is nauseated and has a mid-dilated poorly reactive

Question

A 39-year-old woman presents with painful red eye, blurred vision and haloes around lights. She is nauseated and has a mid-dilated poorly reactive pupil. Intraocular pressure measured by tonometry is 54 mmHg. What is the most appropriate next step in management?

Accepted Answer

Give urgent ocular pressure-lowering treatment and same-day ophthalmology referral

Answer

Reassure because haloes are typical of migraine

Answer

Patch the eye and review in 48 hours

Answer

Treat with topical chloramphenicol alone

Answer

Give oral prednisolone and arrange routine optometry

Acute angle-closure glaucoma — SCE Acute Medicine MCQ

A 39-year-old woman presents with painful red eye, blurred vision and haloes around lights. She is nauseated and has a mid-dilated poorly reactive pupil. Intraocular pressure measured by tonometry is 54 mmHg. What is the most appropriate next step in management?