Which symptom profile is most characteristic of acute angle-closure glaucoma?

• A. Gradual vision loss over months
• B. Sudden eye pain with halos around lights, redness, and blurred vision
• C. Chronic tearing with photophobia
• D. Floaters and flashes of light

Answer: (B)

Acute angle-closure glaucoma is an ophthalmic emergency driven by a rapid rise in intraocular pressure. The defining symptom pattern is sudden, severe eye pain with halos around lights, a red eye, and blurred vision, often with headache and sometimes nausea or vomiting. The pupil is frequently mid-dilated and poorly reactive, and corneal edema can intensify the halos, all signaling abrupt angle closure. This presentation contrasts with gradual vision loss over months, which fits chronic open-angle glaucoma; tearing with photophobia, which points to surface irritation or conjunctivitis; and floaters with flashes, which suggest retinal detachment. The hallmark combination of abrupt pain, halos, red eye, and sudden visual blurring is what makes this profile characteristic and warrants urgent evaluation to prevent optic nerve damage.