J Korean Ophthalmol Soc > Volume 57(2); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(2):334-340.
DOI: https://doi.org/10.3341/jkos.2016.57.2.334    Published online February 1, 2016.
A Case of Bilateral Acute Angle Closure Attack Induced by Common Cold Medication.
Eun Hee Hong, Min Jee Lee, In Seok Song
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea. francis33@naver.com
종합감기약 복용 후 발생한 양안 급성 폐쇄각발작 1예
한양대학교 의과대학 안과학교실
The authors report a case of bilateral simultaneous acute angle closure attack following administration of an over-the-counter common cold medication (ingredients: chlorpheniramine maleate, phenylephrine hydrochloride, and belladonna alkaloid). CASE SUMMARY: A 67-year-old man visited the emergency room with a sudden onset of bilateral blurred vision and ocular pain accompanied by headache, nausea, and vomiting. He had taken an over-the-counter common cold medication three times per day for three days before the visit. His visual acuity was 0.3 and 0.7 and intraocular pressure (IOP) was 50 mm Hg and 40 mm Hg in right and left eye, respectively. The refraction in manifest refractive test was +0.75 D sph = -0.75 D cyl x 100 in right eye and +1.25 D sph = -1.25 D cyl x 80 in left eye. The anterior chamber depth was three times the corneal thickness in center and less than 1/4 of the corneal thickness in periphery in both eyes on van Herick method. The angles of both eyes were closed on gonioscopy. He was treated with ocular hypotensive medication and miotics followed by withdrawal of common cold medications. After 10 days, bilateral neodymium-doped yttrium aluminium garnet (Nd:YAG) laser peripheral iridotomies were done. During four months of follow-up, there was no recurrence of angle closure attack, and normal IOP was maintained without glaucoma medications. CONCLUSIONS: Common cold medications which are easily accessible can induce acute angle closure attack in those who are predisposed to develop angle closure attacks, hence attention must be taken in those people when taking common cold medications.
Key Words: Bilateral acute angle-closure;Common cold medication;Intraocular pressure;Relative pupillary block

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