Dr.V.V. Lakshmi Narasimha Rao, Dr.Veera Venkata Satyanarayana Kunche, Dr.Ravinaini Kosti

Abstract

STUDY DESIGN:case presentation
PURPOSE:To present a case of drug induced angle closure glaucoma
METHODS:A 43 year old female patient presented with headache to the ER,GIMSR and was started on T.Pregabalin,T.Nortryptiline and cap Duloxetine.She developed blurring of vision and pain in both eyes after 24hrs.Past history showed usage of T.Duloxetine for migraine.Ocular examination showed decreased visual acuity,circumciliary congestion and corneal edema.Anterior chamber showed VH-1 depth.IOP was 56mm of Hg both eyes.Patient was started on i.v Mannitol 1g/kg wt and T.Acetazolamide 500mg STAT.Post infusion pressures were 42mm of Hg in both eyes and gonioscopy showed closed angles.She was given a course of anti glaucoma treatment and treated with Nd:YAG LPI.Post LPI IOP was 18mm Hg.
RESULTS:Patient's condition improved gradually after LPI and stopping offending drugs.
CONCLUSION:Duloxetine,Nortryptiline and Pregabalin can induce acute angle closure glaucoma in predisposed individuals.