Elevated intraocular pressure in glaucoma indicates what?

• A. It confirms optic neuritis
• B. It rules out glaucoma
• C. It indicates a risk for acute angle-closure glaucoma
• D. It indicates macular degeneration

Answer: (C)

Elevated intraocular pressure signals a danger that the drainage system of the eye may be compromised enough to precipitate acute angle-closure glaucoma, especially in eyes with shallow anterior chambers. When the pupil or iris blocks the trabecular meshwork, aqueous humor outflow is acutely obstructed, causing a rapid, dangerous spike in pressure. This sudden rise is an emergency because it can quickly damage the optic nerve and threaten vision if not treated promptly.

Other conditions listed aren’t driven by high intraocular pressure in the same way: optic neuritis involves inflammation of the optic nerve and is not defined by IOP levels; glaucoma can occur with normal or elevated IOP, so an elevated pressure does not rule glaucoma in or out; macular degeneration is unrelated to intraocular pressure. The important point is that a high IOP particularly raises concern for the risk of acute angle-closure glaucoma.