What is the primary treatment for acute angle closure glaucoma?

The primary treatment for acute angle closure glaucoma is intravenous acetazolamide. This condition is characterized by a sudden increase in intraocular pressure due to the closure of the anterior chamber angle, which prevents proper drainage of aqueous humor from the eye.

Intravenous acetazolamide is a carbonic anhydrase inhibitor that effectively reduces the production of aqueous humor, thereby helping to lower the intraocular pressure quickly. This rapid action is critical in acute situations where immediate pressure reduction is necessary to prevent damage to the optic nerve and preserve vision.

Other treatments, such as oral carbonic anhydrase inhibitors, while effective, typically do not act as quickly as IV administration, making them less suitable for emergency situations. Topical corticosteroids and topical antihistamines are not appropriate for treating acute angle closure glaucoma as they do not directly address the underlying cause of increased eye pressure. Instead, their mechanisms and indications pertain to managing inflammation or allergic responses, which are not the primary concerns in this acute scenario.

In summary, intravenous acetazolamide is the preferred choice due to its rapid effectiveness in lowering intraocular pressure in patients experiencing acute angle closure glaucoma.