Drug induced acute myopia with supraciliary choroidal effusion in a patient with Wegener's granulomatosis

A-scan ultrasonography has been used to measure anterior chamber depth and lens thickness during the myopic phase. 3 Ultrasound biomicroscopic (UBM) imaging during the acute phase has only been reported twice. 4, 5 We present a case of drug induced bilateral transient myopia with shallow anterior chambers, where UBM aided in the diagnosis and provided clues to the mechanism responsible for this reaction. To our knowledge acute myopia and ciliary body oedema due to renal failure has not been described as an ocular manifestation of Wegener's granulomatosis, or as a direct consequence of acute renal failure in the presence of Wegener's granulomatosis.\n Although a relation between Wegener's granulomatosis and the development of acute myopia cannot be completely ruled out, such a relation is unlikely. The proposed mechanisms responsible for this myopic shift are: (1) spasm of accommodation, (2) lens oedema, (3) ciliary body oedema with associated choroidal effusion. 8 Of these proposed mechanisms, spasm of accommodation is the most unlikely, as cycloplegic instillation almost never abolishes the refractive error change in medication induced acute transient myopia.