Treatment of Chronic Angle-Closure Glaucoma Presenting with Headache, Eye Pain, and Markedly Elevated Intraocular Pressure
Clinical Scenario
This protocol applies to an acute angle-closure crisis (AACC): occluded anterior chamber angle with symptomatic, markedly elevated intraocular pressure requiring urgent management.
Presentation
- Occluded anterior chamber angle
- Markedly elevated intraocular pressure
- Headache and eye pain
- Nausea and vomiting
- Blurred vision with halos
- Corneal edema
- Conjunctival and episcleral vascular congestion
- Mid-dilated pupil
Treatment Approach
Medical therapy is initiated first to lower intraocular pressure. The regimen draws on agents that target aqueous humor dynamics — the full protocol specifies which agents apply, in which clinical circumstances, and what additional interventions may be required.
Full agent selection, sequencing, and procedural options are available in the complete protocol.
Goal: lower IOP · reduce pain · clear corneal edema
References
DOI: 10.1016/j.ophtha.2025.12.030
- Acute angle-closure crisis (AACC): occluded angle with symptomatic high IOP
- Symptoms of AACC include eye pain, headache, nausea/vomiting, and blurred vision with halos.
- Clinical signs of AACC are markedly elevated IOP, corneal edema, conjunctival and episcleral vascular congestion, and/or a mid-dilated pupil.
- In AACC, medical therapy is usually initiated first to lower the IOP to reduce pain and clear corneal edema.
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