Wolf in sheep's clothing: Cough syrup-induced synergistic idiosyncratic mydriatic reaction precipitating a bilateral acute angle-closure attack in a predisposed hypermetropic patient

Abstract

An uncommon ophthalmic emergency condition, bilateral acute angle-closure glaucoma (AACG), is a potentially sight-threatening adverse effect of several local and systemic drugs in high-risk individuals. The majority of cases with drug-induced pupillary block closed-angle glaucoma are preventable, if high-risk patients are recognized and treated prophylactically. We report one such case that highlights the risk factors and rare pathophysiological mechanism of developing bilateral AACG attack after consumption of an antitussive drug orally.

Keywords

• acute attack of angle-closure glaucoma
• bilateral acute congestive glaucoma
• idiosyncrasy
• pupillary block