Cotrimoxazole-induced angle closure attack: A paradoxical treatment

Abstract

An elderly female came to the Emergency with acute onset diminution of vision, redness, and pain in both eyes for a day. Examination revealed best-corrected visual acuity of OU–finger counting at half meter, corneal edema, shallow anterior chamber, and very high intraocular pressures in both eyes. Further history revealed intake of oral cotrimoxazole a day before the presentation. B-scan revealed shallow choroidal effusion inferotemporally OU. Thus, a diagnosis of drug induced, “nonpupillary block” glaucoma was made. This case report describes how a cycloplegic relieved the angle closure attack in contrast to the standard treatment of pilocarpine and laser iridotomy. The case is also reported to make ophthalmologists aware of this unusual complication of a very commonly prescribed antibiotic.

Keywords

• choroidal effusion
• co-trimoxazole
• cycloplegic
• nonpupillary block glaucoma
• shallow anterior chamber