{"id":3679,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/acutelyraisedintraocularpressure\/"},"modified":"2026-01-28T11:48:27","modified_gmt":"2026-01-28T11:48:27","slug":"acutelyraisedintraocularpressure","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ophthalmology\/acutelyraisedintraocularpressure\/","title":{"rendered":"Acutely Raised Intraocular Pressure"},"content":{"rendered":"\n<p>Acutely raised intraocular pressure with a hazy cornea,\nsevere pain and abnormal pupil should be referred as an emergency as a\npotential acute angle closure glaucoma. The pupil is typically mid-dilated and\nnon-reactive to light. <\/p>\n\n\n\n<p>The pain with acute angle closure is typically severe and\nmay be associated with nausea\/vomiting. Analgesia may not improve the pain and\nreducing the pressure with IV acetazolamide +\/- IV mannitol is effective. <\/p>\n\n\n\n<p>It is also useful to note any family history of glaucoma in\nthe referral and any new medications. <\/p>\n\n\n\n<p>Raised intra-ocular pressure may also occur acutely in a few\nother situation e.g. uveitis due to herpes simplex virus or post-operatively.\nPatients with oil in situ following retinal detachment surgery can also have\nacutely raised intra-ocular pressure. <\/p>\n\n\n\n<p>JC &amp; BC 28\/1\/26<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-\u2013-Lothian-GP-and-Optometry-Ophthalmology-Referral-Pathway.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-\u2013-Lothian-GP-and-Optometry-Ophthalmology-Referral-Pathway.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Please see Lothian GP and optometry ophthalmology referral pathway<\/a>.<\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urgency-of-the-condition.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urgency-of-the-condition.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Urgency of the condition<\/a>&nbsp;for details on how soon patients should receive an appointment.<\/p>\n\n\n\n<p>Please see condition specific information for descriptions and management of many common ophthalmological conditions.<\/p>\n\n\n\n<p>Patients who present with a problem with their only seeing eye should be advised to see an optician\/ophthalmologist for review.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p><strong>We require a referral letter for EVERY patient<\/strong>.<\/p>\n\n\n\n<p>The preferred referral process is via SCI Gateway. If sending\/forwarding a referral via SCI gateway please include past medical history, allergies and medications<\/p>\n\n\n\n<p>If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.<\/p>\n\n\n\n<p>Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.<\/p>\n\n\n\n<p>If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Acutely raised intraocular pressure with a hazy cornea, severe pain and abnormal pupil should be referred as an emergency as a potential acute angle closure glaucoma. The pupil is typically mid-dilated and non-reactive to light. The pain with acute angle closure is typically severe and may be associated with nausea\/vomiting. Analgesia may not improve the<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4212,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[465],"class_list":["post-3679","page","type-page","status-publish","hentry","category-acutelyraisedintraocularpressure"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/ophthalmology\/acutelyraisedintraocularpressure\/\" rel=\"tag\">Acutely Raised Intraocular Pressure<\/a>","rttpg_excerpt":"Acutely raised intraocular pressure with a hazy cornea, severe pain and abnormal pupil should be referred as an emergency as a potential acute angle closure glaucoma. The pupil is typically mid-dilated and non-reactive to light. The pain with acute angle closure is typically severe and may be associated with nausea\/vomiting. Analgesia may not improve the","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3679","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3679"}],"version-history":[{"count":11,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3679\/revisions"}],"predecessor-version":[{"id":26361,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3679\/revisions\/26361"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4212"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3679"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3679"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}