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One Minute Clinics at Oaks Hospital with Mr Chrysostomos (Chrys) Dimitriou, Consultant Eye Surgeon .

We ask Mr Dimitriou 'is there any type of emergency glaucoma that needs to be treated asap'?

Glaucoma is one of the leading causes of blindness worldwide and can cause irreversible damage to the field of vision (i.e. loss of driving licence) or actual visual acuity (i.e. affecting reading) if not treated early. One of the types of glaucoma, called acute angle closure, is a devastating condition in which sky high pressure develops inside the eye, most commonly in a hyper-acute fashion within hours or few days, leading to permanent optic nerve damage, if not caught and treated within the first hours of occurrence.

While on the one hand open-angle glaucoma is the “silent thief of vision”, since it rarely produces any symptoms for the patient, acute angle-closure glaucoma (AACG) can cause severe eye pain, headaches, dizziness and even vomiting. The affected eye (almost always one of the two eyes affected in each episode) becomes very red with blurry vision and an unresponsive pupil. The front window of the eye (the cornea) can also become cloudy. Older patients with small eyes, of Asian origin, positive family history for glaucoma, and with high spectacle prescription for long-sightedness (hypermetropia – hyperopia) are particularly at high risk for AACG and may develop some warning signs (prodromal symptoms) like early frontal headaches, eye aches, haloes around lights, photophobia, cloudy vision, especially early morning or in the evenings, as a result of high pressure continuing to rise inside either eye.

Immediate massaging of the affected eye by pressing on the upper eyelid (on-off) might help decompress the build up of pressure (corneal digital massaging) until the patient seeks emergency attention by a specialist ophthalmologist. AACG is one of the most common acute conditions seen by eye specialists and require urgent referrals for immediate initiation of appropriate medical and occasionally surgical treatment (either emergency or subsequent). Prophylactic laser peripheral iridotomy (tiny hole in the coloured disc of the eye) or early cataract extraction is normally the first step in preventing AACG in predisposed eyes, whereas in the acute phase there are additional measures required, sometimes including intravenous drugs to help relieve eye pressure. A glaucoma specialist ophthalmologist’s early intervention as soon as possible is key to success, in terms of preventing or at least minimising the damage caused by acute angle-closure glaucoma.

Always consult your Optician and/or GP should you be concerned about your eyes or book a routine or urgent appointment to see one of our Professional Eye Specialist

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