A 42-year-old patient presented to the emergency department with a one-day history of decreased visual acuity (VA).
His personal history included depression under treatment.
She had no antecedents of interest and denied previous use of glasses.
Its treatment consists of olanzapine 10mg, lorazepam 2mg and venlacrin 150mg retard for several months.
A week before, she had started taking cough to lose weight.
The VA is to count fingers at one meter in both eyes (AO), which improved to 20/40 with stenopeic.
Biomicroscopic examination revealed corneal edema and conjunctival chemosis, a narrow anterior chamber and angular closure evidenced by gonioscopy.
Intraocular pressure (IOP) is 55mmHg in BE.
The diagnosis of bilateral ACG is therefore made.
Topical treatment with pilocarpine 2% (Colircusí Pilocarpina 2%®, Alcon-Cusí, Barcelona, Spain), Chimolol 0.5% (Cusimolol® tablet Alcon 0.5%®,
At two hours the IOP was 30 and 32mmHg, respectively.
24 hours after the first visit, vision remains the same.
Biomicroscopically, corneal oedema, intraocular pressure is 28mmHg and 30mmHg, respectively.
A BU was performed using an AOmmonic ultramycomic antechamber epithelium (AVISO, Quantel, Clermont-Ferrand, France) with a 50 MHz probe showing a narrow anterior ciliary body.
The patient is diagnosed with secondary ACG associated with ciliochoroidal detachment.
Pilocarpine is currently discontinued and treatment with ocular hypotensive agents is continued.
According to the prescription physician, it was decided to discontinue the medication.
1.
Five days after removal of the target sound, the patient had a VA of 20/40 in BE that improved to 20/20 with a grade of -2 spherical in BE.
IOP is 10 and 12mmHg, respectively.
Biomicroscopically, the amplitude of the anterior chamber normalizes.
A new BMU was performed, showing a total disappearance of uveal effusion and conjunctival chemosis, the amplitude of the anterior chamber normalized (3.54mm) as well as the opening of the angle.
The papillae of AO are normal.
Three months after the onset of symptoms, the patient remains stable.
