Acute Glaucome

General information

The acute Glaucome by closing of the angle is an ophthalmologic urgency. Two key points: the 2 eyes are predisposed… thus it exists a risk of bilateralisation and repetition if a preventive medication is not made!

Physiopathology

It is due to the constitutional narrowness of the irido-corneal angle thus occurs especially at the hypermétrope (too short eye) and having a Cristallin of large size (thus with the age because the crystalline lens inflates as one ages). These predisposed subjects risk with the favor of a starting circumstance which occurred of a Mydriase, a closing of their irido-corneal angle, from where a HTO (ocular hypertonicity) brutal and important (50, 60 even 80 MmHg!).

This brutal HTO will threaten the optical nerve in the 6 hours. If no treatment is set up, a total and final functional loss of the vision of the eye will occur.

In the event of effective cure and early: restitution generally AD integrum, or at the tiny prices of after-effects sometimes.

Clinical signs and positive diagnosis

Fall of vision in the shape of an intense fog
Pain: impression which the eye is tightened or which it will burst
important
Pupille without reflex photomotor and rather dilated ocular Rougeur (semi mydriase)
very hard Oeil compared with the other with palpation bidigitale
Parfois signs extraoculaires by reflex vagal: nauseas,…

All in all, the symptoms of a crisis characteristics are so noisy that it is difficult for the person reached not to consult.

The diagnosis is more difficult in the larval forms, subaigues (see clinical forms).

Supporting factors (mydriase)

The release of a GAFA is supported by all that can involve a mydriase:

- Passage to the darkness - Eye lotions mydriatic (Atropine, cyclopentolate,…) - Drugs parasympatholytic - Sympathomimetic Drugs

Clinical forms

The diagnosis is more difficult in the larval forms, subaigues where the less worrying table for the person is likely to delay the diagnosis. It is thus necessary to attach importance to the following symptoms: intermittent perception of fog or halations around the lights accompanied by a unilateral orbital pain or of cephalgia.

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