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Bilateral simultaneous acute angle closure glaucoma precipitated by non‐prescription cold and flu medication
Author(s) -
Rudkin Adam K,
Gray Tim L,
Awadalla Mona,
Craig Jamie E
Publication year - 2010
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2010.01338.x
Subject(s) - medicine , anticholinergic , vomiting , nausea , glaucoma , anesthesia , ophthalmology , atropa belladonna , intraocular pressure , mydriatics , medical prescription , traditional medicine , pharmacology , pupil , neuroscience , biology
We present a case of a 63‐year‐old woman who presented to an ED with bifrontal headache, nausea and vomiting and reduced visual acuity. Examination revealed bilateral elevated intraocular pressures, corneal haze, shallow anterior chambers and poorly reactive, mid‐dilated pupils. Diagnosis was made of simultaneous bilateral acute angle closure glaucoma. A complete drug history revealed that she had been using an over‐the‐counter cold and flu remedy whose active ingredients included atropa belladonna, an herb with anticholinergic properties. It is likely that drug‐induced dilatation of the individual's pupils precipitated this angle closure emergency. In the report we discuss the risk factors for angle closure glaucoma, and review the local and systemic drugs known to trigger this sight‐threatening emergency.