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We describe a case of medically treated acute primary angle closure (APAC) resulting in severe visual loss owing to retinal haemorrhage. We are unaware of previous reports on this phenomenon in the world literature.
A 65-year-old woman visited her optometrist for a routine check. Her pupils were dilated and no pathology was found. Her vision progressively deteriorated that evening.
She attended the hospital and was noted to have unreactive mid-dilated pupils bilaterally. Visual acuity was 20/60 OU (pinhole). Intraocular pressure (IOP) was 60 mm Hg OD and 66 mm Hg OS. Gonioscopy showed occluded angles. The patient had moderate hypermetropia but otherwise had no other ocular risk factors for angle closure.
A diagnosis of iatrogenic APAC was made and the patient was given intravenous acetazolamide, topical dexamethasone, iopidine 1% and pilocarpine 4%.
Ninety min later, IOPs was found to …
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