Author: Monica Kelada / Editor: Sarah Edwards / Codes: / Published: 16/08/2024
A 72-year-old Chinese male with a two day history of floaters in his right eye attends the emergency department (ED) with a terrible headache over his right eye. He feels nauseous, describes the pain as the worst possible pain, and is unable to answer your questions due to the pain.
After reviewing his notes, you find that he is long-sighted and has a short axial length. Importantly, you note that he attended ED this morning and had his pupils dilated to rule out a retinal tear. Shortly after returning home, his headache symptoms began and worsened acutely.
Ocular examination reveals a mid-dilated right pupil with a hazy cornea. On slit lamp examination, no evidence of retinal tears is seen. Intraocular pressure (IOP) measured by applanation Goldman tonometry was 39 mmHg on the right, 18 mmHg on the left.
