Which feature differentiates acute angle-closure glaucoma from open-angle glaucoma?

Which feature differentiates acute angle-closure glaucoma from open-angle glaucoma?

• A. Gradual progressive peripheral vision loss
• B. Painless red eye with normal IOP
• C. Severe itching with watery discharge
• D. Sudden onset and severe eye pain with halos

Answer: (D)

The key idea is how the two types of glaucoma present in terms of timing and symptoms. Acute angle-closure glaucoma shows a sudden, dramatic attack with severe eye pain, red eye, halos around lights, and often vision loss and nausea. This is an emergency and contrasts with open-angle glaucoma, which develops slowly and is typically painless, with gradual peripheral vision loss over years. The option describing a sudden onset and severe eye pain with halos matches the emergency, acute presentation that differentiates angle-closure from the chronic, painless course of open-angle glaucoma. The other choices reflect conditions or patterns not characteristic of acute angle-closure: gradual peripheral vision loss points to open-angle glaucoma; a painless red eye with normal intraocular pressure isn’t typical for a glaucomatous attack; itching with watery discharge suggests allergic conjunctivitis rather than glaucoma.

The key idea is how the two types of glaucoma present in terms of timing and symptoms. Acute angle-closure glaucoma shows a sudden, dramatic attack with severe eye pain, red eye, halos around lights, and often vision loss and nausea. This is an emergency and contrasts with open-angle glaucoma, which develops slowly and is typically painless, with gradual peripheral vision loss over years.

The option describing a sudden onset and severe eye pain with halos matches the emergency, acute presentation that differentiates angle-closure from the chronic, painless course of open-angle glaucoma. The other choices reflect conditions or patterns not characteristic of acute angle-closure: gradual peripheral vision loss points to open-angle glaucoma; a painless red eye with normal intraocular pressure isn’t typical for a glaucomatous attack; itching with watery discharge suggests allergic conjunctivitis rather than glaucoma.