Needle decompression of the eye! Emergent management of a vision threatening surgical complication

Am J Emerg Med. 2022 Jan:51:428.e1-428.e3. doi: 10.1016/j.ajem.2021.06.078. Epub 2021 Jul 9.

Abstract

Acute angle-closure glaucoma (AACG) is a medical emergency that can cause permanent visual deficits without prompt recognition. From 2006 to 2011, nearly 12 million visits to emergency departments (ED) in the United States were ophthalmologic in nature, making it crucial for emergency physicians to be familiar with the diagnosis and treatment of ophthalmologic emergencies. AACG can be precipitated by several mechanisms including pupillary block, anticholinergic medications, and sympathomimetic medications. We present a rare case of angle-closure glaucoma status post pneumatic retinopexy with cryotherapy due to migration of an intravitreal gas bubble into the anterior chamber with emphasis on understanding how retinal surgery types lead to significant differences in management.

Keywords: AACG; Angle closure glaucoma; Glaucoma; Intra-ocular pressure; Pneumatic retinopexy; Retinal detachment; Tono-pen; Tonometry.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Anterior Chamber / pathology*
  • Cryotherapy / adverse effects
  • Decompression / methods*
  • Glaucoma, Angle-Closure / etiology*
  • Glaucoma, Angle-Closure / surgery
  • Humans
  • Male
  • Middle Aged
  • Needles
  • Retina / surgery*