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CASE REPORT
Year : 2021  |  Volume : 1  |  Issue : 3  |  Page : 509-511

Dangerous and deadly phenytoin-induced idiosyncratic mydriatic reaction in an epileptic patient precipitating a bilateral acute angle-closure attack


1 Medical Officer, Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
2 Medical Officer, Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
3 Chief Medical Officer, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
4 Head of Department of Cataract and Refractive Surgery. Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India

Correspondence Address:
Dr. Prasanna Venkatesh Ramesh
Mahathma Eye Hospital Private Limited, No.6, Seshapuram, Thennur, Trichy - 620 017, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2862_20

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A 52-year-old woman presented with acute bilateral ocular pain, headache and vomiting. Examination revealed bilateral circum-corneal congestion, 360° closed angles with a shallow chamber and sluggish mid-dilated pupil. Intraocular pressure was 40 and 42 mm Hg in OD and OS respectively. On vigilant history taking, patient revealed administration of Phenytoin for her epileptic event recently. The suspected drug was stopped and the symptoms reversed. YAG PI was performed, visual acuity improved to 20/20 with reduction of intraocular pressures to normal. This case highlights the risk of developing bilateral acute angle-closure attack after Phenytoin administration.


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