BMJ  2006;333:1157-1158 (2 December), doi:10.1136/bmj.39024.570313.AE

Practice

Lesson of the week

Misdiagnosis of angle closure glaucoma

Patel Gordon-Bennett, senior house officer in ophthalmology, Tsiang Ung, specialist registrar in ophthalmology, Chris Stephenson, consultant ophthalmologist, Melanie Hingorani, consultant ophthalmologist

1 Department of Ophthalmology, Hinchingbrooke Hospital, Huntingdon PE29 6NT

Correspondence to: P Gordon-Bennett, Department of Ophthalmology, Princess Alexandra Hospital, Harlow CM20 1QX  patelgordon@yahoo.co.uk

Be suspicious for angle closure glaucoma in patients with headache, blurred vision, or red eye

The first 150 words of the full text of this article appear below.

Angle closure glaucoma is a sight threatening ophthalmic emergency. Patients classically present with an acutely painful red eye and periocular headache, loss of vision, nausea, and vomiting, but sometimes the presentation is less dramatic or more systemic than ocular. The diagnosis may be missed in such cases, leading to unnecessary investigations, delayed treatment, and blindness. We describe three cases of angle closure glaucoma in which initial diagnostic uncertainty led to a delay in treatment and which highlight the need for a wider awareness of this condition.

A 66 year old woman was admitted to the orthopaedic ward for elective spinal canal decompression for spinal stenosis. She was otherwise healthy and was taking oral diclofenac, morphine, and amitriptyline.

During the operation, she was placed prone for spinal laminectomy. Postoperatively, she received regular opiate analgesia. On the third postoperative day the patient developed severe headache, photophobia, and neck stiffness without focal neurological . . . [Full text of this article]


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  • Edgcombe, H., Carter, K., Yarrow, S. (2008). Anaesthesia in the prone position. Br J Anaesth 100: 165-183 [Abstract] [Full text]  

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