Painful, red eye with a mid-dilated pupil and a need for aggressive drug therapy and peripheral iridotomy describes which glaucoma?

Painful, red eye with a mid-dilated pupil and a need for aggressive drug therapy and peripheral iridotomy describes which glaucoma?

• A. Open-angle glaucoma
• B. Closed-angle glaucoma
• C. Diabetic retinopathy
• D. Iritis

Answer: (B)

This scenario describes acute angle-closure glaucoma. When the iris blocks the drainage angle, aqueous humor cannot exit the eye, causing a rapid and harmful rise in intraocular pressure. The painful, red eye with a mid-dilated, poorly reactive pupil is a classic sign of this condition. Because the pressure climbs so quickly, aggressive medical therapy is needed to lower it promptly, and a peripheral iridotomy is performed to create a new pathway for fluid to flow, relieving the blockage. In contrast, open-angle glaucoma is usually painless and develops gradually without a red eye, diabetic retinopathy involves retinal blood vessels, and iritis is an inflammatory condition—none of these fit the acute, angle-blocking picture.

This scenario describes acute angle-closure glaucoma. When the iris blocks the drainage angle, aqueous humor cannot exit the eye, causing a rapid and harmful rise in intraocular pressure. The painful, red eye with a mid-dilated, poorly reactive pupil is a classic sign of this condition. Because the pressure climbs so quickly, aggressive medical therapy is needed to lower it promptly, and a peripheral iridotomy is performed to create a new pathway for fluid to flow, relieving the blockage. In contrast, open-angle glaucoma is usually painless and develops gradually without a red eye, diabetic retinopathy involves retinal blood vessels, and iritis is an inflammatory condition—none of these fit the acute, angle-blocking picture.