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Acute angle closure triggered by oral benzodiazepines
Alexis Galeno Matos1, Pedro Duarte Barreto Castillo1, João Augusto Lima Bisneto2
1Fundação Leiria de Andrade, Fortaleza, CE, Brazil.
Arquivos Brasileiros De Oftalmologia
|February 10, 2021
Summary
Long half-life benzodiazepines like clonazepam and alprazolam can cause acute angle closure glaucoma. This report details two young patients successfully treated with laser iridotomy after experiencing this rare ocular side effect.
Area of Science:
- Ophthalmology
- Pharmacology
- Toxicology
Background:
- Benzodiazepines are widely prescribed psychoactive medications with largely unknown ocular side effects.
- Acute angle closure glaucoma is a serious condition that can lead to irreversible vision loss, particularly in elderly populations.
Discussion:
- This case report highlights two patients under 45 who developed bilateral acute angle closure glaucoma.
- The condition was secondary to the use of long half-life benzodiazepines: clonazepam and alprazolam.
- This represents the first documented instance of this specific adverse reaction linked to these particular benzodiazepines.
Key Insights:
- Benzodiazepine-induced acute angle closure glaucoma can occur in younger individuals.
- Prompt cessation of the offending medication and ocular hypotensive treatment are crucial.
- Bilateral peripheral laser iridotomy proved to be a successful treatment modality in these cases.
Outlook:
- Further research is warranted to elucidate the mechanisms behind benzodiazepine-induced angle closure glaucoma.
- Ophthalmologists and prescribers should be aware of this potential ocular side effect.
- Screening for risk factors may be beneficial in patients initiating long-term benzodiazepine therapy.
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