Answer: These findings suggest acute angle closure glaucoma, which is causing elevated intraocular pressures. However, the bilateral nature makes a secondary cause, such as drug induced, more likely. While bilateral acute angle closure glaucoma is possible, the presence of myopic shift from anterior rotation of the ciliary body, and ciliary effusions, confirms a secondary, non-pupillary block mechanism for this angle closure (see next page, Diagnosis & Conclusions, for a more in depth discussion).
Which of the following treatments are indicated for this patient (click all that apply):
Emergent laser iridotomy
Instill IOP lowering drops
Administer topical cycloplegic drops
Administer topical steroid drops
Discontinuation of topiramate
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Case 9 Index
Case 9: Introduction
Case 9: Additional History and Physical Exam
Case 9: Ophtho Exam