Most red eyes are usually not sight threatening and can recover without leaving any permanent damage to the eye.

However, one of the red eyes that may require immediate attention is Acute Angle Closure Glaucoma. Acute angle closure glaucoma is vision or sight threatening and needs urgent and timely treatment to prevent irreversible damage to the optic nerve. Optic nerve is the “cable” that connects the eye to the brain and once it is damaged it cannot regenerate.

Some symptoms of acute angle closure glaucoma besides a red eye are usually headaches (in very severe cases nausea and vomiting), pain in the eye associated with blurring of vision and sometimes seeing haloes (due to swelling of the cornea due to increased intraocular pressure).

Acute angle closure glaucoma, is a true ocular emergency and needs to be treated urgently to prevent irreversible damage to the optic nerve.

The first thing to do is to reduce the intraocular pressure (IOP) with topical/oral anti-glaucoma medications. In certain cases, patients may require intravenous (IV) medications too. The doctor will also treat the inflammation with steroid eye drops.

Laser peripheral iridotomy (LPI) needs to be done as soon as possible to the affected eye and also for the other eye to prevent a similar problem in the future. Iridotomy is a procedure where we create a hole in the iris (with laser). If it not possible, then it has to be created surgically, to relieve the pupillary block due to angle closure glaucoma.

Once the IOP is controlled with laser treatment and anti-glaucoma medications and the affected eye has stabilized, there is a need to plan for cataract surgery in the future. All these are done to reduce and prevent irreversible damage to the optic nerve and thus maintain quality of life.