Abstract
Bilateral acute angle closure attack is a rare ocular emergency. Early diagnosis and immediate intervention can have a profound effect on patient’s visual outcome and ocular morbidity. A 70 year old female presented with vomiting about 7 to 8 episodes along with sudden diminution of vision in both eyes for last 3 days. Initially she was examined by physician where all the routine blood tests and upper GI endoscopy was advised which failed to reveal the cause. She was then referred to our department for ophthalmic evaluation. On ocular examination she was diagnosed as a case of bilateral acute angle closure attack with some unusual clinical features. After treatment with hyperosmotic agent, anti glaucoma drugs and Nd: Yag peripheral laser iridotomy, intraocular pressure came down to normal limits and the patient regained good vision.
Highlights
Acute angle closure attack is an ophthalmic emergency that progresses to blindness if untreated
Since most cases of Acute Angle Closure (AAC) are unilateral, we have reported a case of bilateral AAC with some unusual clinical features
Patient was seen after two months of attack, where her best corrected visual acuity (BCVA) was 6/6 in both eyes and intraocular pressure (IOP) was stabilized to 12 and 10 mmHg in right eye (RE) and left eye (LE) respectively
Summary
Acute angle closure attack is an ophthalmic emergency that progresses to blindness if untreated. Acute Angle Closure (AAC) attack presents with a sudden onset of pain or aching on the side of the affected eye. Ocular examination shows markedly raised intraocular pressure (IOP), corneal edema, shallow anterior chamber, mid-dilated and sluggishly reactive pupil, closed angle and peripheral anterior synechiae on gonioscopy.
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