What signs would prompt urgent evaluation for acute angle-closure glaucoma?

• A. Sudden eye pain, headache, halos around lights, vomiting, red eye, mid-dilated fixed pupil, and corneal edema.
• B. Gradual peripheral vision loss over months.
• C. Itchy eyelids with mild discharge.
• D. Double vision with normal intraocular pressure.

Answer: (A)

When the eye suddenly becomes extremely painful with a rapid rise in pressure inside the eye, you’re looking at an emergency in glaucoma. The signs that point to acute angle-closure glaucoma are the sudden eye pain, a severe headache, halos around lights, nausea or vomiting, a red eye, a mid-dilated fixed pupil, and a cornea that looks swollen or hazy. This combination reflects a rapid, dangerous increase in intraocular pressure that can quickly damage the optic nerve, so urgent evaluation is essential to lower the pressure and prevent permanent vision loss.

The other scenarios don’t fit this urgent emergency: gradual peripheral vision loss over months suggests chronic glaucoma; itchy eyelids with mild discharge points to conjunctivitis or blepharitis; double vision with normal intraocular pressure hints at a neurologic or ocular motor issue rather than an acute pressure spike. If the acute signs appear, seek urgent care immediately.