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Abstract #28212 Published in IGR 13-1

Bilateral simultaneous acute angle closure glaucoma precipitated by non-prescription cold and flu medication

Rudkin AK; Gray TL; Awadalla M; Craig JE
EMA - Emergency Medicine Australasia 2010; 22: 477-479


We present a case of a 63-year-old woman who presented to an ED with bifrontal headache, nausea and vomiting and reduced visual acuity. Examination revealed bilateral elevated intraocular pressures, corneal haze, shallow anterior chambers and poorly reactive, mid-dilated pupils. Diagnosis was made of simultaneous bilateral acute angle closure glaucoma. A complete drug history revealed that she had been using an over-the-counter cold and flu remedy whose active ingredients included atropa belladonna, an herb with anticholinergic properties. It is likely that drug-induced dilatation of the individual's pupils precipitated this angle closure emergency. In the report we discuss the risk factors for angle closure glaucoma, and review the local and systemic drugs known to trigger this sight-threatening emergency.

A.K. Rudkin. Department of Ophthalmology, Flinders Medical Centre, Bedford Park, SA 5042, Australia. rudkin.adam@gmail.com


Classification:

9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)



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