Acute glaucoma attack

An acute attack of glaucoma can develop at any stage of the disease. It can develop without any externally visible reasons. In other cases, the appearance of an acute attack of glaucoma is facilitated by a strong emotional shock, an infectious disease, errors in eating or drinking, erroneous instillation of atropine or other means of dilating the pupil into the eye. Therefore, when treating elderly patients prone to increased intraocular pressure, it is necessary to refrain from prescribing these means.

An acute attack of glaucoma in a healthy eye often occurs without any apparent reason.

An acute attack of glaucoma begins suddenly, most often at night or in the morning. There is a sharp pain in the eye, orbit. The headache is accompanied by vomiting, general weakness of the body. Patients lose sleep and appetite. Such general symptoms of an acute attack of glaucoma can be the cause of diagnostic errors.

An acute attack of glaucoma is accompanied by pronounced symptoms from the eye: swelling of the eyelids and conjunctiva, and lacrimation often appears.

Pronounced congestive injection of the vessels of the eyeball and conjunctiva of the eyelids. Sometimes conjunctival chemosis appears. The appearance of a sharply expressed congestive injection of the conjunctiva is associated with difficulty in the outflow of blood from the eye through the vortex veins. The vessels (veins) of the anterior segment of the eye are dilated and tortuous due to characteristic congestion; the cornea is edematous-cloudy, punctured, rough and insensitive to touch. The anterior chamber is shallow, since the iris is injected. A sharp dilation of the pupil, its lack of reaction to light are noted. It is impossible to examine the fundus of the eye in detail with an ophthalmoscope due to corneal edema. Vision is sharply reduced. An acute attack of glaucoma is accompanied by a sharp increase in intraocular pressure (up to 60-70 and even 90 mm Hg), the eye is hard as a stone to the touch. In severe cases, vision can be sharply reduced to the point of loss of light perception. There have been cases of complete blindness after the first such attack (lightning glaucoma). More often, however, all the symptoms of acute glaucoma gradually disappear after a few days, but after each such attack, vision is reduced to a greater or lesser extent. Very rarely there is only one such attack, usually attacks are repeated, but their initial severity decreases, the disease can take on the character of chronic glaucoma. An acute attack of glaucoma can be confused with acute iritis or iridocyclitis. In this case, the introduction of atropine into the eye, necessary for iritis, can be fatal for a patient with glaucoma. To avoid such a serious mistake, it is necessary to know the comparative signs of glaucoma and iritis.

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