The important feature here is that acute glaucoma occurs in long-sighted people and there is usually a previous history of headaches and seeing haloes around lights in the evenings. The raised intraocular pressure damages the iris sphincter and for this reason, the pupil is semi-dilated. Oedema of the cornea causes the eye to lose its luster and gives the iris a hazy appearance (Figure 7.3). The eye is extremely tender and painful and the patient could be nauseated and vomiting. Immediate admission to hospital is essential, where the intraocular pressure is first controlled medically and then bilateral laser iridotomies or surgical peripheral iridec-tomies are performed to relieve pupil block. Mydriatics should not be given to patients with suspected narrow-angle glaucoma without consultation with an ophthalmologist.
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