MSRA-1736

MSRA-1736

A 57-year-old male presents to eye casualty with a one-day history of a painful red eye. He has a past medical history of hypertension and type II diabetes mellitus. He wears glasses for his hypermetropia.

Upon examination of the right eye, a ciliary injection accompanies a fixed mid-dilated pupil. The pain is exacerbated when assessing pupillary reaction, which is non-reactive. His visual acuity is markedly reduced in his right eye compared to his left.

Gonioscopy was performed, and the trabecular meshwork was not visualised. What is the first-line management for this likely diagnosis?