Bilateral acute angle-closure glaucoma with visual impairment precipitated by use of tricyclic antidepressants
Keywords:
antidepressive agents, tricyclic, depression, glaucoma, angle-closure , intraocular pressure, trabeculectomyAbstract
Acute angle-closure glaucoma is an important cause of morbidity in the elderly. A case is described of a patient with narrow angle who had an attack of bilateral acute angle closure glaucoma, precipitated by the use of tricyclic antidepressants. The patient had an increase in intraocular pressure with ocular pain and decreased vision bilaterally, after starting treatment with amitriptyline for endogenous depression. After treatment with antiglaucomatous drugs, peripheral iridotomy was performed. The pressure did not decrease significantly. A trabeculectomy was performed on both eyes. Despite the treatment, severe visual impairment occurred in this case. lt is suggested that antidepressant drugs should be prescribed cautiously in patients at risk for glaucoma ,and the patients should be monitored by an ophthalmologist.
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