Dr. SUJITHA RAMESH

DR. A. VIJAYALAKSHMI, DR. KRISHNA DAS R.

Abstract

32-year male, presented with acute onset defective vision in both eyes(OU) for 1 week. He was treated with tablet escitalopram 10 mg for anxiety disorder 2 weeks back prescribed elsewhere. BCVA OD is 6/18 and 6/6 with myopic shift (-4D).Anterior segment examination OU revealed shallow anterior chamber(VH1) with no reaction and occludable angles on gonioscopy.Intraocular pressure was OD 26mmHg and OS 24 mm Hg. Bscan OU showed 360 degree choroidal effusion. UBM OU revealed ACD 0.89mm (OD) and 1.95mm (OS) with ciliary body edema and anterior rotation with supraciliary fluid pushing the iris lens diaphragm forward suggestive of secondary angle closure. Hence a diagnosis of drug induced (Escitalopram) induced bilateral angle closure secondary to cilichoroidal effusion was made. Patient was started on aqueous suppressants and advised neurologist opinion regarding withdrawal of escitalopram drug and switch to alternate drug. This case is being reported because of its rarity.