Acute angle closure glaucoma - A potential blind spot in critical care

Area of Science:

• Ophthalmology
• Critical Care Medicine

Background:

• Acute angle closure glaucoma is an ophthalmic emergency.
• Critical care patients are at increased risk due to medications like sympathomimetics and beta agonists.
• Sedation can delay diagnosis, necessitating a high index of suspicion.

Purpose of the Study:

• To report a case of acute angle closure glaucoma in a critical care patient.
• To highlight the risk factors and management of this condition in the intensive care unit setting.

Main Methods:

• A 69-year-old male patient on invasive mechanical ventilation developed acute eye pain and vision loss.
• Ophthalmology consultation diagnosed acute angle closure glaucoma.
• Treatment included pilocarpine eye drops, intravenous acetazolamide, and bilateral YAG laser iridotomies.

Main Results:

• The patient experienced immediate symptom relief following treatment.
• He made an excellent recovery from the ophthalmic emergency.

Conclusions:

• Acute angle closure glaucoma is a serious condition that can occur in critical care settings.
• Awareness of predisposing medications and the potential for delayed diagnosis is crucial for timely intervention.
• Prompt diagnosis and management, including laser iridotomies, can lead to favorable outcomes.