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Severe ocular side effects with acetazolamide: case report.

A Llovet-Rausell1, F Ruiz Tolosa1, B Kudsieh1

  • 1Instituto Universitario Barraquer, Universidad Autónoma de Barcelona, Barcelona, España.

Archivos De La Sociedad Espanola De Oftalmologia
|May 16, 2016
PubMed
Summary
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Acetazolamide can cause iatrogenic acute angle closure by displacing the irido-lenticular complex. Discontinuing the drug and using topical eye drops resolved the condition, reducing myopia and eye pressure.

Area of Science:

  • Ophthalmology
  • Pharmacology

Background:

  • Acute angle closure glaucoma is an ophthalmic emergency.
  • Iatrogenic causes of glaucoma require prompt identification and management.

Observation:

  • A patient presented with acute visual decline, elevated intraocular pressure, and shallow anterior chambers.
  • Ultrasound revealed choroidal detachment and increased lens thickness.
  • Initial treatment included naproxen and acetazolamide for presumed migraine.

Findings:

  • Discontinuation of acetazolamide and initiation of topical timolol, brimonidine, prednisolone, and cyclopentolate led to improved vision.
  • Myopia, lens thickness, and intraocular pressure decreased, while anterior chamber depth increased.
  • The patient's final prescription was -0.75 D (OD) and -0.25 D (OS), with normalized intraocular pressure and anterior chamber grade.
Keywords:
AcetazolamidaAcetazolamideAcute cilio-choroidal effusionAngle-closureCierre angularEfusión cilio-coroideaIatrogenesisIatrogeniaMiopizaciónMyopisation

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Implications:

  • Acetazolamide can induce acute angle closure by causing anterior displacement of the irido-lenticular complex.
  • Management involves drug withdrawal and topical therapy to reduce intraocular pressure and myopia.
  • This case highlights the importance of considering medication side effects in diagnosing and treating ophthalmic conditions.