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Abstract #82811 Published in IGR 20-4

Single Dose of Pseudoephedrine Induces Simultaneous Bilateral Acute Angle Closure Crisis

Spencer BG; Baskin J; Giarola BF; Craig JE
Case Reports in Ophthalmology 2019; 10: 365-368


Simultaneous bilateral acute angle closure crisis (AACC) is a sight-threatening ocular emergency. Many "cold and flu" preparations contain compounds with sympathomimetic or anticholinergic qualities that confer a risk of inducing AACC. We present a review of cold and flu preparation-induced AACC, and present a case of simultaneous bilateral AACC triggered by a single oral dose of pseudoephedrine. The challenges facing the clinician in recognizing simultaneous bilateral AACC in the context of an upper respiratory tract infection are addressed. An awareness of this uncommon clinical entity, its pertinent clinical features, risk factors, and the drug classes that may precipitate an attack is critical for the timely diagnosis and management of this ocular emergency. Notably, clinicians must be aware that even a single dose of an implicated medication may trigger an attack of AACC.

Training Medical Officer Unit, Flinders Medical Centre, Adelaide, South Australia, Australia.

Full article

Classification:

9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)



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