Acute angle closure glaucoma or acute angle closure crisis (first presentation so no real glaucoma with nerve damage but such high pressures there should be nerve damage)

Acute primary angle closure crisis (angle = cornea and iris)

Risk Factor

• shallow chamber
• Small eyes - hyperopia, vice versa for far-sightedness = shallow anterior chamber
  • Shallow = higher risk of getting angle closure
  • May done preventative measure: laser to open a hole on iris →  iridotomy
• Big eyes - Myopia = elongated eye = deep anterior chamber

Presentation

• Unilateral, sudden onset, painful red eye, Blurry Vision , Hazy Cornea
• Headache
• N/V - Nausea/vomitting
• Anisocria: fixed, mid-position, dilated pupil (due to Iris ischemia)
• Prior angle closure attacks leave deposits (lens ischemia leaves whitish flecks)
  • Glaucomflecken eye

Physical Exam:

• Eyes exam shows fixed, mid-position, dilated pupil (due to Iris ischemia)
• Slit lamp exam
  • shin light from lateral
  • If iris shadow falls on most of the eye with tangential light = shallow chamber