An 18-year-old woman was referred from the emergency department by the Internal Medicine Department because she reported blurred vision in both eyes for 5 days.
The only antecedents were hypothyroidism treated with levothyroxine 100 micrograms/noches, and headaches for those prescribed nadolol 40 mgrs/noches, and recently cough 25 mgrs/noches.
It provides a recent analytical study, prior to treatment, within normal limits.
a Visual acuity in anterior cylinder, or left atrium measuring 75th, 6 months before (10/10) and +0.50th sphere in right eye
A new refractive study was carried out determining a myopic shift in both eyes with -4.25 sphere -0.50 cylinder to 110o in right eye and -3.75 sphere -1.00 cylinder to 60/10 visual acuity in left eye.
1.
The biomicroscopic study showed mild hyperemia and conjunctival congestion in both eyes, narrow anterior chambers with positive ellipse sign and transparent corneas and crystalline lenses, without inflammatory signs or seclusion.
Cholesterols and normoreactive.
Normal ocular motility.
Intraocular pressure measured with applanation tonometer was 32 mmHg in the right eye and 29 mmHg in the left eye.
The posterior pole and papillae were normal.
1.
Under the suspicion of acute angular closure, oral treatment was initiated with an anhydrol enteric acidase inhibitors (acetazolamide 250 mg), 1⁄2 cp every 8 hours, and topical treatment with bimatoprost and maleate recent thymol
At 24 hours he showed tensions of 23 mmHg in both eyes, and 13 mmHg in the right eye and 12 mmHg in the left eye at 48 hours, with normal depth of the anterior chamber; therefore, topical acetamide was progressively reduced in the third treatment.
1.
Vision was completely normalized at 72 hours, with visual acuity equal to unit in both eyes and refraction similar to that prior to the episode.
A final diagnosis of myopia and ocular hypertension due to acute angular closure secondary to the treatment with cough was made, which was communicated to the patient, family and internal medicine service as the prescriber of the drug.
