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Abstract #92613 Published in IGR 22-1
Bilateral Acute Angle Closure Glaucoma after Prone Position Ventilation for COVID 19 Pneumonia
Nerlikar RR; Palsule AC; Vadke SJournal of Glaucoma 2021; 30: e364-e366
We report a case of bilateral acute angle closure glaucoma developing after prone position ventilation for severe COVID 19 pneumonia. A 53-year-old diabetic and hypertensive male developed blurred vision and ocular discomfort in both eyes after prone position ventilation for severe COVID 19 pneumonia. At initial examination he was noted to have diffuse corneal edema with shallow anterior chambers and mid dilated non reacting pupils. His intraocular pressure was 48 & 54▒mm Hg in right and left eye respectively. Following intravenous mannitol (20%) infusion, oral acetazolamide 250▒mg three times daily, along with topical therapy with combination Brimonidine and Brinzolamide eye drops and Fluoromethalone eye drops his corneal edema resolved and subsequent to laser iridotomy his intraocular pressures lowered significantly and could be maintained below 16▒mm Hg in both eyes with topical therapy alone. With prone position ventilation being a commonly employed adjuvant treatment for acute respiratory distress syndrome associated with COVID 19 pneumonia, acute angle closure may be precipitated in these patients if they have pre-existing narrow angles. Awareness of the possibility and its recognition may allow prompt ophthalmic referral, early treatment and minimise visual consequences.
Department of Ophthalmology, Deenanath Mangeshkar Hospital and Research Centre, Erandawne, Near Mhatre Bridge, Pune 411004, India.
Full articleClassification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
15 Miscellaneous