Abstract

Drug induced bilateral acute secondary angle closure crisis is an Ophthalmic emergency that can lead to vision threatening sequelae if not recognized and treated promptly. Various Sulphonamide derivatives and certain serotonergic mediations like topiramate, acetazolamide, diuretics, SSRI are implicated in this peculiar phenomenon. It is pertinent to emphasize that they are known to precipitate bilateral, acute angle closure attack by idiosyncratic mechanism, with no predisposing narrow angles. We present a case of bilateral acute angle closure crisis secondary to oral Acetazolamide, in a 66-year-old male who underwent RRD surgery in right eye. The diagnosis was challenging in view of a few misleading events. The case highlights the cues to be picked up to not misdiagnose to prevent vision threatening sequalae. It also focuses on the fine line of differentiation between acute primary angle closure and acute secondary angle closure.

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