Angle-Closure Glaucoma on Long-Haul Flights

IMPORTANCE: Unlike other modes of long-distance travel, long-haul flights delay urgent, specialist medical treatment until the destination is reached or the plane is diverted. Angle-closure glaucoma (ACG) occurring during those flights results in considerable morbidity and may cause permanent visual loss. It is preventable in patients with risk factors but may be an underrecognized and underreported phenomenon on long-haul flights. OBSERVATION: We report a case series of 3 patients with ACG that developed on long-haul flights. The patients presented to 2 ophthalmic institutions for treatment in the south of England between 2010 and 2012. All patients were female and hypermetropic, and all experienced considerable morbidity while awaiting medical treatment that was not available in flight. CONCLUSION AND RELEVANCE: Individuals with risk factors should be advised on the symptoms of ACG and the appropriate course of action should those symptoms occur. Prophylactic therapy with pilocarpine, 2%, eyedrops may be useful for individuals with risk factors who are embarking on long-haul flights. Airline personnel should be aware of ACG and encouraged to consider the value of training cabin crews to provide appropriate first-aid measures.