A rare acute presentation of simultaneous bilateral angle closure in a patient using a red light therapy mask

To describe a case of acute-onset bilateral angle-closure glaucoma secondary to ciliochoroidal effusions in a 43-year-old otherwise healthy female. An autoimmune and inflammatory work-up was negative, and the patient was not on any medications or supplements. She had been using a red-light therapy (RLT) mask over the past two weeks, including the morning of her presentation.

The underlying mechanism of the patient's presentation was most consistent with secondary angle-closure due to ciliochoroidal effusions and anterior rotation of the ciliary body. The only recent lifestyle change was the new use of RLT mask therapy for over two weeks. With prompt diagnosis, close outpatient monitoring, cessation of the RLT mask use, and careful titration of IOP-lowering, cycloplegic, and steroid medications, the patient returned to her baseline vision of 20/20 OU and had bilateral choroidal effusions resolve.

Choroidal effusions have not been previously described in association with at-home RLT mask use; however, existing evidence suggests that RLT exposure may increase choroidal vascularity and thickness. Following cessation of RLT and appropriate medical management, the patient had complete resolution of the ciliochoroidal effusions and full recovery of vision. Further investigation is warranted to better characterize the ocular safety profile of RLT devices.