What preliminary treatment should be administered before referring a PACG patient to a specialist?

Pilocarpine eye drops are the appropriate preliminary treatment for a patient with acute primary angle-closure glaucoma (PACG) prior to specialist referral. This medication is a miotic agent, which means it helps to constrict the pupil and facilitate the drainage of aqueous humor from the anterior chamber of the eye. By promoting pupillary constriction, pilocarpine decreases intraocular pressure, which is critical in managing PACG, where rapid increases in eye pressure can lead to vision loss if not treated promptly.

When considering the urgency of PACG, prompt intervention is essential to alleviate symptoms and prevent complications. Administering pilocarpine can stabilize the patient temporarily while ensuring they are referred to an ophthalmologist for further evaluation and management.

In this context, other treatments listed would not have the same effect on managing the intraocular pressure in PACG and addressing the immediate needs of the patient. For instance, topical anesthetic drops may assist in certain procedures but do not address the underlying condition. Oral antihistamines would not be effective in this scenario, as they are used for treating allergic reactions, not eye pressure issues. Systemic corticosteroids may be beneficial in certain inflammatory conditions of the eye but are not a first-line treatment for acute PACG