A patient presents with sudden, extremely painful eye symptoms including a red eye, blurred vision, halos around lights, and vomiting. The cornea is hazy and the pupil reacts poorly to light. What is the most likely diagnosis?

A patient presents with sudden, extremely painful eye symptoms including a red eye, blurred vision, halos around lights, and vomiting. The cornea is hazy and the pupil reacts poorly to light. What is the most likely diagnosis?

• A. Increased Intracranial Pressure
• B. Acute Angle Glaucoma
• C. Detached Retina
• D. Macular Degeneration

Answer: (B)

Acute angle-closure glaucoma is suggested by the sudden, extremely painful red eye with blurred vision, halos around lights, vomiting, a hazy cornea, and a pupil that reacts poorly to light. In this condition, the iris blocks the outflow of aqueous humor at the angle, causing a rapid rise in intraocular pressure. The high pressure leads to corneal edema, which makes the cornea appear hazy and creates diffraction halos around lights. The iris and pupil become ischemic and poorly reactive to light. This combination of sudden eye pain, red-eye appearance, visual disturbance with halos, systemic symptoms like vomiting, and a cloudy cornea with a poorly responsive pupil is classic for an ophthalmic emergency that requires urgent treatment to lower intraocular pressure and prevent vision loss. Other conditions don’t fit as well: increased intracranial pressure can cause headache and vomiting but not the red eye with halos or a hazy cornea; a detached retina typically presents with a sudden, painless loss of vision and floaters rather than acute eye pain and corneal edema; macular degeneration produces gradual central vision loss rather than an abrupt, painful red eye with halos.

Acute angle-closure glaucoma is suggested by the sudden, extremely painful red eye with blurred vision, halos around lights, vomiting, a hazy cornea, and a pupil that reacts poorly to light. In this condition, the iris blocks the outflow of aqueous humor at the angle, causing a rapid rise in intraocular pressure. The high pressure leads to corneal edema, which makes the cornea appear hazy and creates diffraction halos around lights. The iris and pupil become ischemic and poorly reactive to light. This combination of sudden eye pain, red-eye appearance, visual disturbance with halos, systemic symptoms like vomiting, and a cloudy cornea with a poorly responsive pupil is classic for an ophthalmic emergency that requires urgent treatment to lower intraocular pressure and prevent vision loss.

Other conditions don’t fit as well: increased intracranial pressure can cause headache and vomiting but not the red eye with halos or a hazy cornea; a detached retina typically presents with a sudden, painless loss of vision and floaters rather than acute eye pain and corneal edema; macular degeneration produces gradual central vision loss rather than an abrupt, painful red eye with halos.