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Glaucoma, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

Disease characterized by elevation of intraocular pressure, optic neuropathy, and progressive loss of vision. 

Etiology

  • Primary glaucoma:

    • Open-angle glaucoma:

      • Normal anterior chamber ang...

Diagnosis

Signs and Symptoms

Classic descriptions: 
  • Open angle:

    • Painless and gradual loss of vision

  • Closed angle:

    • Painful loss of vision with fixed midsized pupil

History

  • Primary open-angle glaucoma:

    • Gradual ...

Treatment

Pre-Hospital

  • No specific interventions need occur prior to arrival at the hospital in regard to the eye:

    • Pain control may be necessary

    • In traumatic etiologies, stabilize other injuries

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

  • Severe pain, nausea, or vomiting

  • Patients receiving parenteral medications should be observed for side effects.

  • Patients without improvement of symptoms or intraoc...

Pearls and Pitfalls

  • Increased IOP can cause vascular insufficiency and with delayed treatment vision loss can be permanent

  • Eye pain/headache can be associated with severe abdominal pain—do not ignore t...

Additional Reading

  • Chew  P, Sng  C, Aquino  MC, et al. Surgical treatment of angle-closure glaucoma. Dev Ophthalmol.  2012;50:137–145.

  • Dargin  JM, Lowenstein  RA. The painful eye. Emerg Med Clin N...

Codes

ICD9

  • 365.9 Unspecified glaucoma

  • 365.11 Primary open angle glaucoma

  • 365.22 Acute angle-closure glaucoma

  • 365.60 Glaucoma associated with unspecified ocular disorder

  • 365.31 Corticosteroid-induced glauco...

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