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Anna Elizabeth Mao1, Daniella Bach-Holm1

  • 1Afdeling for Øjensygdomme, Københavns Universitetshospital - Rigshospitalet.

Ugeskrift for Laeger
|September 2, 2024
PubMed
Summary

A pregnant woman with migraine symptoms was misdiagnosed with a migraine attack but actually had acute angle closure glaucoma. Prompt diagnosis is crucial for preventing permanent vision loss.

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Area of Science:

  • Ophthalmology
  • Neurology

Background:

  • Migraine with aura can present with neurological symptoms that may overlap with other conditions.
  • Acute angle closure glaucoma is an ophthalmic emergency characterized by sudden increased intraocular pressure.

Observation:

  • A pregnant woman experiencing headache, nausea, and blurred vision was initially diagnosed with migraine.
  • Clinical examination revealed bilateral fixed and dilated pupils, ptosis, and tearing, suggesting an alternative diagnosis.

Findings:

  • The patient was diagnosed with bilateral acute angle closure glaucoma, not a migraine attack.
  • Despite normalized visual acuity after treatment, severe visual field defects persisted at one-year follow-up.

Implications:

  • This case highlights the importance of considering non-migrainous diagnoses in pregnant women with visual disturbances.
  • Delayed diagnosis of acute angle closure glaucoma can lead to irreversible visual field defects and significant impact on daily life.

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