Question:
A patient reports seeing halos around lights and has a painful red eye with decreased vision. Intraocular pressure is markedly elevated. Which diagnosis is most likely?
Answer:
Acute angle-closure glaucoma is correct because typically it presents with sudden onset of severe ocular pain, a red eye, blurred or decreased vision and characteristic halos around lights due to corneal edema. In this condition, the anterior chamber angle becomes blocked, preventing normal outflow of aqueous humor and causing a rapid rise in intraocular pressure. The corneal edema scatters light, creating halos, and the high pressure can lead to nausea, vomiting, and headache as well. This is an ophthalmic emergency because prolonged elevated IOP can quickly damage the optic nerve, potentially leading to permanent vision loss.
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