**Core Concept**
Acute congestive glaucoma, also known as acute angle-closure glaucoma, is a medical emergency characterized by a sudden increase in intraocular pressure (IOP) due to blockage of the trabecular meshwork. This condition can lead to optic nerve damage and vision loss if not promptly treated.

**Why the Correct Answer is Right**
The treatment of choice in acute congestive glaucoma involves reducing IOP to prevent optic nerve damage. This is achieved through a combination of pharmacological and surgical interventions. The initial treatment typically involves administering topical and systemic medications to decrease IOP, including beta-blockers, alpha-agonists, and carbonic anhydrase inhibitors. Topical pilocarpine, a muscarinic receptor agonist, is also used to constrict the pupil and increase aqueous outflow. In severe cases, surgical interventions such as iridotomy or trabeculectomy may be necessary.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not address the immediate need to reduce IOP in acute congestive glaucoma.
**Option B:** This option is incorrect as it is not the primary treatment for acute congestive glaucoma. While steroids may be used in some cases, they are not the first line of treatment in this condition.
**Option C:** This option is incorrect as it does not accurately represent the treatment for acute congestive glaucoma.

**Clinical Pearl / High-Yield Fact**
In acute congestive glaucoma, prompt recognition and treatment are critical to preserve vision. The classic symptoms include severe eye pain, headache, nausea, vomiting, and vision changes, often accompanied by a mid-dilated, non-reactive pupil.

**Correct Answer: C. Pilocarpine**