EyeRounds Online Atlas of Ophthalmology
Contributor: Andrew Doan, MD, PhD, University of Iowa
Category: Glaucoma / Iris
Acute angle closure glaucoma
1) Patient awoke with severe pain OD, headache, decreased vision OD, and nausea. Photo shows unilateral redeye with hazy cornea. Right eye was very firm with a pressure of 70+ mmHg. Refractive error was +1.50 to +2.00 sphere in each eye.
2) Examination of the left eye showed a narrow anterior chamber by comparing the width between slit beams.
3) Von Herrick Test showed a narrow angle in the left eye. Distance between slit beams should be at least 1/2 of the corneal thickness (~250 microns). Gonioscopy demonstrated a closed angle OS too.
4) Laser peripheral iridotomies (LPI) were performed on both eyes. Aqueous suppressants were started OD and the pressure dropped.
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