Investigating the Neuroprotective Effect of Cop-1 (Copaxone) in Acute Primary Angle Closure

Inclusion Criteria: * • patients with APAC who present to the centre not later than 7 days from the initiation of the attack. * the presence of at least two of the following symptoms: ocular or periocular pain, nausea or vomiting or both, and an antecedent history of blurring of vision with haloes; * a presenting intraocular pressure of at least 28 mm Hg on Goldmann applanation tonometry; * the presence of at least three of the following signs: conjunctival injection, corneal epithelial oedema, middilated unreactive pupil, and shallow anterior chamber; * the presence of an occludable angle in the affected eye on gonioscopy; * Age more than 21 years. * Informed consent Exclusion Criteria: * • evidence of a prior acute angle closure attack (the presence of iris whorling, focal iris atrophy, or glaucomflecken with a history of an acute red eye and decreased vision). This will not include senile iris and sphincter atrophy); * Pre-existing chronic angle closure glaucoma in the eye with APAC * secondary causes of angle closure like subluxed lens, uveitis, trauma and neovascular glaucoma; * cataract that is deemed significant enough to require surgery during the course of the trial or that makes field testing or optic disc imaging not technically possible- visual acuity less than 6/36 due to any type of cataract; * corneal abnormalities, media opacities, or retinal abnormalities that would affect scanning laser polarimetry; * previous intraocular surgery; …