vi medicine informatics




Acute closed-angle glaucoma is an ophthalmic emergency that typically presents as an intensely painful, firm eye with blurred vision that may be accompanied with a headache. Findings include a fixed-dilated pupil, corneal clouding, and conjunctival injection. It is the result of aqueous humor outflow tract obstruction, which leads to increased intraocular pressure. In this patient, atropine antagonizes M3 receptors, which blocks the trabecular meshwork since the angle is being reduced by the M3 blockade. Since the trabecular meshwork is responsible for 90% of aqueous humor drainage, this dramatically increases intraocular pressure. Other etiologies of closed-angle glaucoma include hypoxia from retinal diseases (eg, diabetes), which triggers vasoproliferation in the iris that similarly obstructs aqueous outflow. Treatment for acute closed-angle glaucoma involves iridotomy or medication that decreases aqueous humor production, such as beta-blockers or alpha-2 agonists.

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