What medications are sent home for AACG patient after initial treatment?

• A. Acetazolamide 250 mg twice daily and Timolol 0.5% twice daily
• B. Prednisone and cycloplegic
• C. Latanoprost nightly
• D. Oral glycerin

Answer: (A)

In acute angle-closure glaucoma, once the attack has been brought under control, the best plan for home management is to maintain the lowered IOP by continuing medications that reduce aqueous humor production. Acetazolamide at 250 mg twice daily works systemically to decrease production of aqueous humor, while timolol 0.5% twice daily adds an additional topical reduction of production at the ciliary body. Together they address the underlying cause of the pressure rise with complementary mechanisms and a practical dosing schedule for ongoing control.

Prednisone with a cycloplegic would not help in this situation and can actually worsen the angle closure by dilating the pupil. Latanoprost or other prostaglandin analogs are useful for open-angle glaucoma but are not the immediate first-line home therapy after an AACG attack. Oral glycerin is an acute hyperosmotic option, not a standard long-term home regimen after stabilization. Therefore, continuing acetazolamide and timolol provides effective, rapid, and safe maintenance after initial treatment.