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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Updated: Oct 12, 2025

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Olanzapine-Induced Acute Angle Closure.

Motazz A Alarfaj1,2, Abdullah I Almater3

  • 1King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

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This case report details a rare instance of acute angle closure glaucoma induced by olanzapine, an atypical antipsychotic. Prompt diagnosis and treatment, including laser peripheral iridotomy, led to significant visual improvement.

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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Emergency Medicine

Background:

  • Drug-induced acute angle closure glaucoma (AACG) is an uncommon but serious ocular emergency.
  • Various drug classes, including adrenergic agonists, anticholinergics, and serotonergic medications, can trigger AACG.
  • Olanzapine, an atypical antipsychotic, is rarely implicated in AACG.

Observation:

  • A 59-year-old male with schizophrenia developed acute right eye pain and decreased vision.
  • Symptoms began one week after initiating olanzapine 5 mg daily.
  • Clinical and radiological findings confirmed drug-induced pupillary block.

Findings:

  • The patient received topical and systemic intraocular pressure (IOP)-lowering agents.
  • A therapeutic Nd:YAG laser peripheral iridotomy was performed on the affected eye.
  • Post-treatment, the patient's symptoms resolved, and his vision significantly improved.

Implications:

  • This case underscores the critical importance of a thorough medical history, including recent medication use, in diagnosing secondary AACG.
  • Physicians across specialties must be aware of medications that can precipitate pupillary block.
  • Educating patients on the symptoms of AACG is crucial for early intervention and prevention of vision loss.