Bilateral acute angle-closure glaucoma occurring after the initiation of hydrochlorothiazide

Acute angle-closure glaucoma (ACG) is an ocular emergency that can result in vision loss. In the literature, there are a limited number of studies reporting that sulfonamide-derived drugs could cause ACG. The case was a 68-year-old male who was started to be followed up with a diagnosis of bilateral primary open-angle glaucoma 3 years ago, and whose intraocular pressures were within normal limits with topical treatments. He presented with bilateral ocular pain, redness, blurred vision, headache, and nausea that started the day before. On examination, a sudden onset of bilateral myopic shift, choroidal effusion, and ACG was detected. Medical history revealed hydrochlorothiazide initiation 3 days ago for hypertension. Hydrochlorothiazide was suspected to be the cause of this clinical picture. After discontinuation of hydrochlorothiazide, along with administration of antiglaucomatous, anti-inflammatory, and cycloplegic agents, these changes were resolved within 2 weeks. It would be better for physicians to inform patients about these potential risks when prescribing hydrochlorothiazide-containing medications.

Keywords: Acute angle-closure glaucoma, choroidal effusion, hydrochlorothiazide, myopia.