Which condition requires immediate medical intervention to prevent vision loss?

• A. Cataracts
• B. Acute angle-closure glaucoma
• C. Myopia
• D. Dry eye syndrome

Answer: (B)

A key idea here is recognizing an ocular emergency where vision loss can happen rapidly if not treated. Acute angle-closure glaucoma is such an emergency. It occurs when the drainage pathway of the eye becomes blocked, causing a sudden, dangerous rise in intraocular pressure. That pressure spike can injure the optic nerve within hours, leading to permanent vision loss if not addressed immediately.

Patients typically report severe eye pain, headaches, nausea or vomiting, halos around lights, and a rapid decrease in vision. Management focuses on quickly lowering intraocular pressure and relieving the obstruction. This usually starts with urgent medications to reduce pressure (systemic agents like acetazolamide and topical eye drops that lower IOP) and proceeds to a procedure such as laser peripheral iridotomy to create a new drainage pathway and prevent future attacks.

Cataracts cause gradual, painless vision decline from lens clouding; myopia is a refractive error that blurs distant vision but isn’t an emergency; dry eye syndrome causes irritation and intermittent blurred vision but does not threaten the optic nerve acutely. The immediate threat to vision in this scenario is the angle-closure glaucoma, so it requires urgent intervention.