Acute angle-closure glaucoma secondary to an aneurysm of the posterior communicating artery

A 57-year-old woman developed pain behind and above her left eye. She had a partial oculomotor nerve paresis manifest by slight blepharoptosis and a dilated pupil. Both anterior chamber angles were narrow but the left was partially occluded. There was no photophobia or corneal edema. Though the moderately increased intraocular pressure was controlled by medication, pain persisted and the oculomotor nerve palsy became complete 12 hours later. Cerebral angiography was done. She had an aneurysm of the left posterior communicating artery. The aneurysm was treated by neurosurgical techniques and the oculomotor paralysis resolved within a few months except for misdirection in regeneration.