What is the onset pattern for primary closed-angle glaucoma?

What is the onset pattern for primary closed-angle glaucoma?

• A. Onset At 6-8 Years; Initially Unilateral With Progression To Bilateral In 5-10 Months
• B. Acute Onset In Adults
• C. Chronic Onset In Elderly
• D. Always Bilateral From Start

Answer: (A)

Primary angle-closure glaucoma most often presents with an acute attack in adults. This pattern fits middle-aged to older individuals who have shallower anterior chambers and often hyperopic eyes; a sudden, painful rise in intraocular pressure occurs, typically in one eye at first. The eye may show redness, halos around lights, severe eye pain, headache, nausea, and a mid-dilated pupil. The second eye can become involved later, but not necessarily within a fixed short time frame. The option describing onset in childhood is not consistent with how this disease usually behaves, and the idea that it is always bilateral from the start doesn’t match the common unilateral first attack with possible contralateral involvement later. A chronic, slowly progressive pattern is possible (more typical of chronic angle-closure glaucoma), but the classic and most tested onset is an acute, unilateral presentation in adults.

Primary angle-closure glaucoma most often presents with an acute attack in adults. This pattern fits middle-aged to older individuals who have shallower anterior chambers and often hyperopic eyes; a sudden, painful rise in intraocular pressure occurs, typically in one eye at first. The eye may show redness, halos around lights, severe eye pain, headache, nausea, and a mid-dilated pupil. The second eye can become involved later, but not necessarily within a fixed short time frame.

The option describing onset in childhood is not consistent with how this disease usually behaves, and the idea that it is always bilateral from the start doesn’t match the common unilateral first attack with possible contralateral involvement later. A chronic, slowly progressive pattern is possible (more typical of chronic angle-closure glaucoma), but the classic and most tested onset is an acute, unilateral presentation in adults.