Dr.Leila Mohan
Bilateral acute narrow angle glaucoma is rare.A 33 year old man being treated for alcoholic de addiction in a psychiatric hospital came with acute blurring of vision .His VA was 4/60 in RE and 5/60 in LE .Anterior chamber was shallow in both eyes.RE showed minimal corneal haze and pupil was sluggish. IOP was 48mm Hg in RE and @20 mm of Hg in LE.Gonioscopy showed closed angles.His treatment details were not available& was admitted .IV mannitol given , IOP measured after1 hour showed IOP of 44 mm Hg in BE as.Antiglaucoma medications were started with acetazolamide 500 mg tablet orally.Next day, IOP came down to 30s in BE.Cornea was clear, but vision did not improve.Refraction showed myopia of _3.0D.On enquiry with his admitting doctor, history of taking Topiramate for 5 days before presentation was obtained.OCT& Bscan showed choroidal effusion&ciliary body oedema. 4 days after presentation his IOP came down to lower teens and after 6 days,VA improved to 6/6 and 6/6.Angles were open.
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