<prompt> A 55 years lady presented with sudden onset of severe pain in the eye with, Shallow anterior chamber. Treatment of choice isAtropineIV mannitol AcetazolamideAtenololSteroids IV  <response>: 1V mannitol Acetazolamide: 242-Nema 6th edition; 244-Khurana 5theIt 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 - 0.005Intensive 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 