An 87-year-old male presented with an acute onset of eye pain and blurry vision in his right eye 1 day prior to his presentation to the ER. He had a history of hypertension and dyslipidemia. The patient was diagnosed with pseudoexfoliation syndrome of the left eye in 2013. The intraocular pressure (IOP) was normal without antiglaucoma medication. The patient denied any history of eye trauma. He had undergone uneventful phacoemulsification with posterior chamber IOL implantation using an AcrySof IOL (model SA60AT) in his right eye 13 years previously and in his left eye 10 years previously. Upon examination, the best-corrected visual acuity (BCVA) in the right eye had significantly decreased from 20/40 to counting fingers at three feet; the left eye had a visual acuity of 20/30. The IOP was 56 mm Hg in the right eye and 16 mm Hg in the left eye. Slit-lamp biomicroscopy of the right eye revealed corneal haze grade 1 with epithelial microcysts, an asymmetrical shallow anterior chamber with iris bombe in the superior region without posterior synechiae, and a fix-dilated, nonreactive pupil (shown in ). No vitreous or fibrin membranes were observed in the anterior chamber. Neither exfoliative material nor loss of pupillary ruff was observed at the pupillary margin of the right eye. The IOL was clear with suspected homogenous whitish fluid behind the IOL, and no pseudophakodonesis was noted. A Soemmering ring located anterior to the IOL optic, along with a fibrotic edge surrounding a small continuous curvilinear capsulorhexis (CCC) with a size of 5 mm, indicative of an in-the-bag IOL position, was observed. The posterior segments were obscured due to media opacity. Slit-lamp biomicroscopy of the left eye showed loss of pupillary ruff and exfoliative material at the pupillary margin; otherwise, it was unremarkable. Gonioscopy revealed a convex iris and 360° iridotrabecular contact in the right eye and a wide-open angle in the left eye. In the right eye, the refraction was −6.25 + 2.25 × 1, and the axial length was 23.07 mm. Anterior segment optical coherence tomography (AS-OCT) was performed to identify the cause of angle closure and confirm the diagnosis of CBS. AS-OCT showed a 360° convex iris configuration with hyperreflective material located between the superior pupillary margin and the IOL, as well as capsular bag distention with hyperreflective fluid between the IOL and posterior capsule, without any opacity in the IOL (shown in ). Compared with the left eye, the IOL in the right eye was in the anterior position, and the anterior chamber was shallower. It was determined that the patient had CBS with pupillary block angle-closure glaucoma. The IOP was controlled by using systemic and topical antiglaucoma medications before further management. Laser peripheral iridotomy (LPI) was performed to eliminate the pupillary block. Subsequently, posterior capsulotomy with an Nd:YAG laser was performed to release turbid fluid into the vitreous cavity. Prompt therapy resulted in the disappearance of whitish fluid and modest deepening of the anterior chamber without an iris bombe (shown in ). The final BCVA was gradually improved to 20/80, and the IOP was decreased to 8 mm Hg with few antiglaucoma medications.