Glaucoma Week Series -episode 9 (Identifying closed angle Glaucoma in a rural setting)

Optom
Closed angle glaucoma is often an emergency eye challenge. Its always acute and often present with epiphora in the ipsilateral eyes. Another classic outlook of closed Angle Glaucoma is monocularity in pathogenesis but often assumes binocularity @ an unpredicted pace! This type of Glaucoma, which most times is accompanied by a secondary or predisposing factor, can affect individuals of any age group.
The following triads are cornerstone gems for suspecting closed Angle Glaucoma in a rural setting-
In Adults
1)sudden onset of pain in one eye and necessarily much epiphora.
2)Redness with corneo-scleral limbal injection, not related to ocular infections, but the cornea is relatively clearer on early presentation.
3)Mid-dilated ipsilateral pupil with sluggish or unreactive pupil to light.
In children
1) Epiphora
2) corneal edema
3)Exophthalmos.

These classical triads are often accompanied with photophobia. The pressure of the eye is visibly high and on external examination one can reveal engorged vessels. The patient can misinterpret the throbbing in the eyeball for a generalized headache. It often does not lead to blindness because of the highly symptomatic nature of Angle closure Glaucoma. In children it almost always binocular in pathogenesis. It is not common to Africa, but an important eye challenge to Asians. Glaucoma is no respecter of sight...lets not play with it! Go for an eye test today, it can make the difference!
To be continued....
Dr Ezebuiroh Victor Okwudiri.