Intended for healthcare professionals

Rapid response to:

Practice Lesson of the week

Misdiagnosis of angle closure glaucoma

BMJ 2006; 333 doi: (Published 30 November 2006) Cite this as: BMJ 2006;333:1157

Rapid Response:

Misdiagnosis of angle closure glaucoma - digital palpation can aid correct diagnosis.

Lesson of the week, “Misdiagnosis of angle closure glaucoma,” highlights the difficulties that non-Ophthalmologists can face in making the correct diagnosis.[1] Without access to tonometry, intraocular pressure can be estimated by gentle digital palpation of the closed eye. In angle closure glaucoma the eye will feel much harder than if the intraocular pressure is normal.[2] Whilst this is a crude method, it is useful for identifying eyes with raised intraocular pressures.[3]

[1] Gordon-Bennett P, Ung T, Stephenson C, Hingorani M. Lesson of the week: Misdiagnosis of angle closure glaucoma. BMJ, 2006. 333: 1157-1158.

[2] Khaw, P.T., Shah, P. and Elkington, A.R. Glaucoma - 1: diagnosis. BMJ, 2004. 328: 97–99.

[3] Baum J, Chaturvedi N, Netland PA, Dreyer EB. Assessment of intraocular pressure by palpation. Am J Ophthalmol. 1995. 119(5): 650-651.

Competing interests: None declared

Competing interests: No competing interests

02 December 2006
Alexander C Day
SpR Ophthalmology
Chelsea and Westminster Hospital, 369 Fulham Road. London. SW10 9NH