“Acute” = “Closed-Angle” = “Narrow-Angle” Glaucoma, as opposed to the much more common chronic, open- / wide-angle glaucoma, which is asymptomatic & insidious. Incidence of acute glaucoma is higher among Asians and Native Alaskans, especially over 50 years-old.Presents with any of
- Severe retro-orbital “headache”; OR
- Painful red eye
- Acute vomiting
- Red eye
- Cloudy cornea
Onset is always acute, because blindness ensues within 24-48 hours without surgery. You won’t miss this as long as you remember to examine the eyes when a patient presents with headache. Send to E.D. stat.
Another reason this gets missed is the clinician hears “Unilateral H/A” and “vomiting,” thus diagnosing “migraine.”