Case Report: Acute Angle-Closure Glaucoma in a 43-Year-Old Male
Introduction Acute angle-closure glaucoma (AACG) is an ocular emergency resulting from a rapid increase in intraocular pressure (IOP) due to obstructed aqueous humor outflow. It is commonly associated with a shallow anterior chamber angle, predisposing individuals to blockage. Without timely intervention, AACG can lead to permanent vision loss or blindness. This report describes the presentation, diagnosis, and management of AACG in a patient presenting to the emergency room (ER). Patient Presentation A 43-year-old male with no significant past medical history presented to the ER on a Sunday afternoon with blurred vision and pain in the right eye that began the day before. He initially hoped the symptoms would resolve on their own but sought medical attention after consulting a healthcare provider. He reported a sharp, constant headache behind the right eye rated 6/10, accompanied by nausea and blurred vision, described as though a film was over the right eye. He also noticed mild redness in the right eye but denied discharge, pain with eye movement, photophobia, fever, chills, respiratory, gastrointestinal, or genitourinary symptoms. Physical Examination Vital Signs: T 98.7°F, P 85 bpm, R 16/min, BP 151/87 mmHg, SpO₂ 97% on room air.Visual Acuity: Right Eye 20/40, Left Eye 20/20. Extraocular Movements (EOM): Full range of motion without pain. External Eye Exam: Eyelids everted—no foreign bodies. Mild conjunctival erythema, no discharge. Corneal Staining: Fluorescein stain showed no corneal uptake. Funduscopic Exam: Right Eye: Cloudy cornea, retina not visualized. Left Eye: Retina visualized, no gross abnormalities. Intraocular Pressure (IOP): Right Eye 76-80 mmHg, Left Eye 14-17 mmHg. Slit Lamp Exam: Not available in the ER. Working Diagnosis Acute Angle-Closure Glaucoma (AACG) Treatment Provided in ER Acetazolamide (Diamox): 500 mg PO (IV formulation unavailable) Timolol 0.5%: 2 drops in the right eye Apraclonidine and Prednisolone ophthalmic solutions were not available. Ophthalmology Consultation: Arranged…