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Bilateral Acute Angle-Closure Glaucoma: A Case Report of an Unusual Cause of Acute Headache in a Child

Authors :
Breelan Kear
Claudia R. Gold
Rahul Bhola
Source :
Clinical Practice and Cases in Emergency Medicine, Vol 5, Iss 4 (2021)
Publication Year :
2021
Publisher :
eScholarship Publishing, University of California, 2021.

Abstract

Introduction: Acute angle-closure glaucoma (AACG) is typically considered a disease of adulthood. However, AACG may occasionally be seen in children. The clinical presentation is similar to adults, including headache, vomiting, and eye pain. However, the etiology of angle closure in children is different and most often associated with congenital anterior segment abnormalities. A precipitating factor of AACG in children with previous established, anterior segment abnormalities is eye dilation, which may occur during routine ophthalmological examination with topical mydriasis, or physiologic mydriasis upon entering a dark room. Case Report: We describe a 5-year-old child with a history of severe prematurity and retinopathy of prematurity (ROP) presenting with bilateral AACG following a routine outpatient, dilated ophthalmological examination. While angle-closure glaucoma has previously been reported in cases of ROP, a bilateral acute attack of AACG following pupil dilation in regressed ROP has hitherto been unreported. Conclusion: Given the association of ROP and AACG, it can be expected that as the survival rate of premature infants improves, the incidence of ROP and AACG may also increase. It is therefore prudent for the emergency physician to have AACG on the differential for pediatric patients with headache and eye pain.

Details

Language :
English
ISSN :
2474252X
Volume :
5
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Clinical Practice and Cases in Emergency Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.85f111cab435468aa282522565ed7c7f
Document Type :
article
Full Text :
https://doi.org/10.5811/cpcem.2021.7.52671