Author: Monica Kelada / Editor: Sarah Edwards / Codes: OptC5, OptP4, OptP5, SLO2 / Published: 16/08/2024
A 72-year-old Chinese male with a two day history of floaters in his right eye attends the emergency department (ED) with ‘a terrible headache over his right eye’. He feels nauseous, describes the pain as the worst possible pain, and is unable to answer your questions due to the pain.
After reviewing his notes, you find that he is long-sighted and has a short axial length. Importantly, you note that he attended ED this morning and had his pupils dilated to rule out a retinal tear. Shortly after returning home, his headache symptoms began and worsened acutely.
Ocular examination reveals a mid-dilated right pupil with a hazy cornea. On slit lamp examination, no evidence of retinal tears is seen. Intraocular pressure (IOP) measured by applanation Goldman tonometry was 39 mmHg on the right, 18 mmHg on the left.
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Question 1 of 3
1. Question
What is the management of angle closure glaucoma?
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What risk factors for acute angle closure glaucoma are present in this case?
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3. Question
His notes also show that his optometrist had previously used a grading system using the slit lamp examination that indicated that mydriatics should be used with caution as he is high risk for angle occlusion.
What is the name of this grading system?
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3 responses
Great Revision
Good refreshing discussion
Good revision of risk factors and initial management