Escitalopram-induced bilateral secondary angle-closure with uncommon associations

Abstract

<br>Acute angle closure is a rare complication in patients receiving antidepressant treatment. We report two uncommon associations of acute-onset myopia with internal limiting membrane folds and soft exudates following the use of escitalopram. A 28-year-old woman, with no prior history of glasses, taking escitalopram for depression, presented with decreased vision. On examination, she was found to have myopic shift in both eyes and intraocular pressure of 38 mm Hg and 40 mm Hg in the right and left eye, respectively. She had closed angles on gonioscopy; anterior displacement of the iris-lens diaphragm on B-scan and undilated fundus examination revealed soft exudates and inner limiting membrane folds at the macula in both eyes. It is highly important that clinicians be made aware of the risk factors associated with drug-induced secondary acute angle closure with an antidepressant. History taking plays a significant role play in view of any hepatic and renal dysfunction.<br>