Intravenous tubing connected to a container of normal saline or lactated Ringer's solution makes an ideal irrigation tool. A lid speculum greatly facilitates irrigation. Continue irrigation with water or normal saline solution for at least 20 minutes. After 20 to 30 minutes, perform a brief eye examination, including vision testing. Therefore, in all patients who present with acute, persistent vision loss, careful history taking and eye examination are important to avoid preventable causes of permanent vision loss going undetected.
Chief complaints can vary from a vague sense of discomfort of the eye to severe nausea and vomiting.
The normal range is 6 to 22 mm Hg. However, intraocular pressure of less than 50 mm Hg is uncommon in patients presenting with acute vision loss and pain. Delayed treatment of pupillary block glaucoma can cause chronic synechial angle-closure glaucoma, permanent corneal edema, retinal vascular occlusions, optic atrophy, and permanent blindness. Even several hours of highly elevated intraocular pressure that goes untreated can result in permanent vision impairment. Table 4 outlines typical initial management of severely elevated intraocular pressure.