Uveal Effusion Following Yttrium Aluminum Garnet (YAG) Iridotomy in a Patient on Acetazolamide: A Case Report

To report a case of uveal effusion after yttrium aluminum garnet (YAG) laser iridotomy in a hyperopic patient on acetazolamide, illustrating the possible interaction between post-laser inflammation and medication-induced changes in intraocular fluid dynamics. A 73-year-old patient was referred for left ocular hypertension and was found to have bilaterally narrow iridocorneal angles, confirmed by gonioscopy and anterior segment optical coherence tomography (AS-OCT). After initial treatment with oral acetazolamide and a prostaglandin analog eye drop, a YAG laser peripheral iridotomy was performed in the left eye following pilocarpine instillation. Six days later, the patient developed persistent peripheral blurred vision in the treated eye. Fundus examination revealed an extensive peripheral serous choroidal detachment with a peripapillary serous retinal detachment. Discontinuation of acetazolamide and initiation of intensive topical corticosteroids led to a progressive resolution of the effusion within one month. Given the risk of recurrence in predisposed eyes and the absence of acute symptoms in the fellow eye, prophylactic iridotomy was deferred in favor of close monitoring. This case illustrates the potential role of an interaction between post-laser inflammation and pharmacologically induced transscleral pressure changes in the occurrence of uveal effusion. By reporting this case, we aim to raise awareness of this rare complication among clinicians to promote early diagnosis and prevent avoidable therapeutic complications.