Acute closed-angle glaucoma

High urgency
-Moderately severe

Glaucoma is a serious eye disease associated with increased intraocular pressure.

It is known as angle-closure glaucoma when its cause is associated with a sudden obstruction in the drainage of intraocular fluid.

Symptoms include severe one-sided eye pain and loss of vision. It is usually associated with symptoms such as nausea, vomiting, headache and a red eye. On examination, the pupil may be dilated and, if there is inflammation of the cornea, the iris may appear hazy.

The diagnosis is made by interview and physical examination. It is confirmed by measuring the intraocular pressure; a direct examination of the drainage channels of the eye to examine the retina may also be carried out.

Urgent treatment is needed. As a first approach, antifungal medication is used to reduce the size of the pupil, which also helps to drain the eye fluid. Diuretics, such as acetazolamide and/or mannitol, are used to drain body fluids and help reduce pressure. Corticosteroids may also be used to reduce inflammation. However, as this is a condition with a clear anatomical component, surgery to modify the iris (iridectomy) or laser (iridotomy) will be required to activate fluid drainage and prevent further episodes.

Bibliographic references
  1. Jennifer S Weizer, MD. Angle-closure glaucoma. UpToDate. Dec 22, 2015.
  2. Prum BE Jr, Herndon LW Jr, Moroi SE, et al. Primary Angle Closure Preferred Practice Pattern(®) Guidelines. Ophthalmology 2016; 123:P1.
  3. Horton JC. Trastornos de los ojos. Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición: 200 y 204-205.
  4. Shields SR. Managing eye disease in primary care. Part 3. When to refer for ophthalmologic care. Postgrad Med 2000; 108:99.
Author
Dr. Sara Vitoria
Copyright
© TeckelMedical 2026

Symptoms

    Vision loss of the visual field is lateral


    Eye pain


    Sudden loss of sight


    Pupil alteration


    Medium-sized pupil, not reactive to light

Pre-hospital care recommendations

Do not leave the person suffering from the disease alone.
Remain calm.