The most common form of angle closure glaucoma is an acute attack. Unlike primary open angle glaucoma, it is not a gradual and subtle disease process. It has a sudden and rapid onset. An acute angle closure attack causes a rapid rise in intraocular pressure. When the pressure becomes extremely high, usually within a few hours, the eye is very painful and can cause the patient to be nauseous and possibly vomit. The eye itself will become extremely red, and the patient may see halos around lights caused by corneal edema. Along with the above symptoms, there is a significant reduction of visual acuity caused by corneal clouding and insufficient vascular supply to the optic nerve head. If left untreated, there may be damage to the optic nerve leading to severe vision loss.

Sudden attacks can be triggered by the dilation of the pupil which causes the lens and iris to be in contact with each other. This can occur by using certain types of drugs (including some anti-histamines, anti-nausea medications, and anti-depressants). Additionally, an attack can occur by being in a very dark room which causes the pupil to dilate. Extreme stress can also cause the pupil to dilate, thus possibly leading to an acute attack.

Patient Symptoms Blurred vision Halos around lights Nausea/vomiting Photophobia Red eye

Clinical Signs Cells and flare present Central retinal artery pulsation or occlusion Conjunctival and ciliary injection Corneal edema Dilated pupil Elevated IOP Optic disc congestion Segmental iris atrophy

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	URL: http://www.opt.indiana.edu/clinics/pteduc/glaucoma/types/aacg.htm Revised: September 12, 2003
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