Acute Angle Closure Crisis with Immature Senile Cataract: A Case Report
DOI:
https://doi.org/10.37287/ijghr.v8i6.2849Keywords:
AACC, PAC, cataract, glaucomaAbstract
Senile cataract causes lens thickening and anterior displacement, which may narrow the anterior chamber angle and obstruct the aqueous outflow, which is marked by an increase in intraocular pressure. Acute angle closure occurs due to sudden closure of the trabecular meshwork located in the anterior chamber angle, resulting in a rapid rise in intraocular pressure. In Indonesia, glaucoma is one of the leading causes of blindness after cataract. This descriptive case report of a single patient aims to describe the clinical presentation, diagnostic evaluation, and management of acute angle-closure crisis in a patient with senile cataract. A 58-year-old woman presented with a 4-day history of a red right eye, worsening pain, progressive blurred vision, and headache radiating from the eye. She also reported blurred vision with halos for 3 months. The visual acuity OD was light perception and the IOP 52.9 mmHg. She was diagnosed with acute angle-closure OD, primary angle closure OS, and bilateral immature senile cataract. After one week medical therapy, the IOP in the right eye was still 38.6 mmHg. The right-eye IOP decreased to 18 mmHg one week after phacoemulsification combined with goniotomy. Prompt evaluation and management are essential to prevent irreversible glaucomatous optic nerve damage.
References
Allen, R. C. , & H. R. A. (2019). Basic ophthalmology: Essentials for medical students (10th ed.). American Academy of Ophthalmology.
Annisa, L., Jasmine, I. Z., & Violita, N. H. (2025). Profil dan Efektivitas Terapi Pasien Glaukoma Rawat Jalan di Rumah Sakit di Yogyakarta. Indones. J. Med. Pharm. Sci, 4(2), 99–109. https://doi.org/10.30659/ijmps.v4i2.451
Chan, P. P., Pang, J. C., & Tham, C. C. (2019). Acute primary angle closure–treatment strategies, evidences and economical considerations. In Eye (Basingstoke) (Vol. 33, Number 1, pp. 110–119). Nature Publishing Group. https://doi.org/10.1038/s41433-018-0278-x
Christine, R. N. (2025). Modul Pengajaran Kepaniteraan Klinik “Glaukoma Sudut Tertutup Akut”.
Firdaus, R. C., Sekarini, A. C., Ariyanto, A., & Hanif, I. (2026). Phacoemulsification Combined with Goniosynechialysis and Goniotomy fzor Primary Angle-Closure Glaucoma: A Mini Systematic Review. Indonesian Journal of Global Health Research, 8(4), 289–300. https://doi.org/10.37287/ijghr.v8i4.2308
Gedde, S. J., Chopra, V., Vinod, K., Bowden, E. C., Kolomeyer, N. N., Challa, P., & Budenz, D. L. (2026). Primary Angle-Closure Disease Preferred Practice Pattern®. Ophthalmology, 133(4), P153–P201. https://doi.org/10.1016/j.ophtha.2025.12.030
Hajar, S., Rakhmawati Emril, D., Banda Aceh, Z., Neurologi Fakultas Kedokteran Universitas Syiah Kuala, K., & Zainoel Banda Aceh, R. (2021). Gangguan Neurologis Pada Glaukoma Neurological Disorders In Glaucoma. In Jurnal Sinaps (Vol. 4, Number 1).
Jeong, Y., Park, K. H., & Jeoung, J. W. (2024). Long-term prognosis of acute primary angle closure in an east asian cohort. Japanese Journal of Ophthalmology, 68(4), 302–310. https://doi.org/10.1007/s10384-024-01065-3
Li, X., Balas, M., & Mathew, D. J. (2025). A Review of Ocular and Systemic Side Effects in Glaucoma Pharmacotherapy. Journal of Clinical & Translational Ophthalmology, 3(1), 2. https://doi.org/10.3390/jcto3010002
Luthfiani Sarah Sophia, & Hayati. (2024). Glaukoma Sekunder Pada Pasien dengan Penggunaan Steroid Topikal Rutin: Laporan Kasus.
Mohamed A. Anbar, Hany A. Mahmoudorcid, & Marwa M. Abdellah. (2023). Angle, anterior chamber parameters, and intraocular pressure changes after early phacoemulsification in acute angle-closure glaucoma. Journal of Cataract & Refractive Surgery, 1147–1152.
Nüßle, S., Reinhard, T., & Lübke, J. (2021). Acute Closed-Angle Glaucoma - An Ophthalmological Emergency. Deutsches Arzteblatt International, 118(45), 771–780. https://doi.org/10.3238/arztebl.m2021.0264
Paul Riordan-Eva, & Emmet T. Cunningham Jr. (2018). Vaughan & Asbury’s: General-Ophthalmology 19th Edition.
Ramadani, D., Papeo, P., Mubaraq, F. S., Ramdan, M., Bumulo, R., Kahar, O., Adati, A., Wahyuni, S., Begali, M. M., Farmasi, J., Olahraga, F., Kesehatan, D., & Gorontalo, U. N. (2023). Kajian Terapi Penggunaan Obat Pasien Glaukoma Terhadap Penurunan Tio Pada Rumah Sakit Di Provinsi Gorontalo Study Of Therapeutic Use Of Medication In Glaucoma Patients To Reduce Iop In Hospitals In Gorontalo Province. In Jurnal Kesehatan Pharmasi (Vol. 126, Number 2).
Riva, I., Micheletti, E., Oddone, F., Bruttini, C., Montescani, S., De Angelis, G., Rovati, L., Weinreb, R. N., & Quaranta, L. (2020). Anterior chamber angle assessment techniques: A review. In Journal of Clinical Medicine (Vol. 9, Number 12). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/jcm9123814
Salmon, J. F. (2024). Kanski Clinical Ophtalmology: A systematic approach. 10th Edition. https://service.elsevier.com/app/home/supporthub/elsevierebooksplus/
Sitorus, R. S., Sitompul, R., Widyawati, S., & Bani, A. P. (2017). Buku Ajar Oftalmologi FK UI Edisi Pertama, Cetakan Ke 2.
Sorokin, E. L., Marchenko, A. N., & Pashentsev, Ya. E. (2022). Phacoemulsification in prevention of acute angle-closure glaucoma attack. Vestnik Oftal’mologii, 138(2), 37. https://doi.org/10.17116/oftalma202213802137
Sun, X., Dai, Y., Chen, Y., Yu, D. Y., Cringle, S. J., Chen, J., Kong, X., Wang, X., & Jiang, C. (2017). Primary angle closure glaucoma: What we know and what we don’t know. In Progress in Retinal and Eye Research (Vol. 57, pp. 26–45). Elsevier Ltd. https://doi.org/10.1016/j.preteyeres.2016.12.003
Xie, B., Yang, Z., Wang, Z., Fang, Z., Song, Y., Lin, F., Xu, G., Zhou, F., Tumbocon, J. A., Han, Y., Tham, C. C., Aung, T., Dada, T., Weinreb, R. N., Li, F., & Zhang, X. (2026). Goniotomy and phacogoniotomy in glaucoma surgery. Asia-Pacific Journal of Ophthalmology, 15(2), 100296. https://doi.org/10.1016/j.apjo.2026.100296
Yosafat, F., Fatimah Sah Ramadhan, S., Rasyid, M., Ilmu Kesehatan Mata, D., & Sumber Waras Kota Jakarta, R. (2026). Laporan Kasus: Glaukoma Absolut Oculus Sinistra. In KOLONI: Jurnal Multidisiplin Ilmu (Vol. 5, Number 3).
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
