This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Glaucoma, Subject name: Ophthalmology
[{'content': 'A 55 years lady presented with sudden onset of severe pain in the eye with, Shallow anterior chamber. Treatment of choice is \nSelect and explain. \nA. Atropine, B. I/V mannitol & Acetazolamide, C. Atenolol, D. Steroids I/V', 'role': 'user'}, {'content': 'Answer: B \nExplanation: (1/V mannitol & Acetazolamide): (242-Nema 6th edition; 244-Khurana 5th/e)It is a case of Acute primary angle closure glaucomaImmediate medical therapy to lower IOP1. Systemic hyper osmotic agents* Intravenous mannitol (1 gm 1 kg body weight)* Oral hyperosmotics eg glycerol2. Systemic carbonic anhydrase inhibitor eg acetazolamide3. Topical antiglaucoma drugs -* Beta blocker - 0.5% timolol or 0.5% betaxolol* Alpha adrenergic agonist eg. brimonidine - 0.1 - 0.2%* Prostaglandin analogue eg - latanoprost - 0.005%Intensive miotopic (Pilocarpine 2%) therapy is not advised now a day4. Analgesics and anti-emetics5. Compressive gonioscopy6. Topical steroid eg - prednisolone acetate 1% or dexamethasone* Laser iridotomy is the treatment of choice for the management of early acute PACG* *** Prophylactic laser iridotomy should be performed on the fellow asymptomatic eye as early as possible as chances of acute attack are 50% in such cases', 'role': 'assistant'}]