Bilateral angle-closure attack in a COVID-19-positive patient

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• Ophthalmic examinations can be complicated in patients with active COVID-19.
• Secondary angle closure is a potential, though rare, ocular complication of viral infections.

Observation:

• A COVID-19-positive woman was initially misdiagnosed with conjunctivitis.
• She later presented with bilateral acute angle-closure attacks, characterized by high intraocular pressure (IOP) around 40 mmHg.
• A non-pupillary block mechanism was suspected, leading to the avoidance of laser iridotomy.

Findings:

• The patient's IOP was effectively managed with topical medications.
• Phacoemulsification with intraocular lens (IOL) implantation was performed, utilizing femto-assisted capsulorhexis to mitigate post-operative IOP spikes.
• Post-surgery, the patient achieved good IOP control and visual acuity of 6/6.

Implications:

• Bilateral angle closure in COVID-19 patients may have multifactorial causes.
• This case highlights the importance of considering atypical ophthalmic presentations in patients with COVID-19.
• Ophthalmologists should be vigilant for angle-closure glaucoma as a potential complication in COVID-19 patients.