Clinical characteristics of drug induced secondary bilateral acute angle‐closure glaucoma

Purpose To describe clinical manifestations, ultrasound biomicroscopy(UBM) findings and treatment outcome of drug induced secondary bilateral acute angle‐closure glaucoma. Methods A retrospective chart review of patients diagnosed with drug induced secondary bilateral acute angle‐closure glaucoma from May 2012 to February 2015, was performed. Results Seven female patients (14 eyes) were included in the study. 6 patients were taking appetite suppressant to lose weight. 1 patient was taking a cold medicine. The mean age was 30.3 ± 6.6 years old. All the patients complained of decreased visual acuity, and 2 of them complained of ocular pain and a headache, either. UBM revealed supraciliary choroidal effusion causing forward displacement of the lens‐iris diaphragm, which resulted in myopia (‐6.07 ± 2.5 diopter), anterior chamber shallowing, and increased intraocular pressure (31.6 ± 7.0 mmHg on the right eye, 31.86 ± 8.1 mmHg on the left eye by Goldmann applanation tonometer) by angle‐closure. Discontinuation of causative drugs and administration of pressure‐lowering agents led to the resolution of the symptoms. Symptoms improved 7.0 ± 3.9 days after initiation of the treatment, and supracilliary choroidal effusion subsided, which was confirmed by UBM findings. No patients required invasive treatment such as laser iridotomy, or developed glaucomatous optic neuropathy. Conclusions Drug induced secondary bilateral acute angle‐closure glaucoma is likely to respond very well to cessation of causative drugs and application of pressure lowering drugs. There were no patients who needed invasive treatment, or developed glaucomatous optic neuropathy.