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The medication regimen in the Emrap summery is different from the on recommended in the Corependium section. This Corependium recommends the medication twice over a 30 min interval. However this summery recommends the medication 3 times in 5min intervals? Which one is correct?
Thanks for the comment!
The CorePendium textbook describes the conventional standard approach to the treatment of acute angle closure glaucoma describing administering the medications at different intervals than described in the EMRAP piece.
We have updated the CorePendium chapter to reflect both approaches including the most recent recommendations from The Wills eye manual: office and emergency room diagnosis and treatment of eye disease. (2022) giving topical medications every 15 minutes and also included in the chapter how local practice patterns may vary as in the EMRAP April 2022, episode, where Dr. Deidre St. Peter, an ophthalmologist, recommends a more rapid approach.
With both of these approaches, we recommend monitoring for systemic effects of the topically administered eye medications, particularly timolol, as with repeated doses systemic effects may occur eg, bradycardia, hypotension, bronchospasm in patients with asthma and COPD although systemic effects can be seen with any of these medications.
Thanks for what you do!Sean
I recently seen a elderly patient, who had acute angle closure glaucoma despite having little to no eye pain and a complaint of blurred vision but with normal visual acuity. She had surgery in 2017 for cataracts. I thought cataract surgery lowered the IOP and diminished the risk of acute glaucoma, but seems it is still possible!
What you do matters.