Bilateral Acute Angle Closure Glaucoma Secondary to Escitalopram in an Elderly Female: A Rare Case Report

Abstract

A 65-year-old woman on escitalopram for depression presented with bilateral ocular pain and decreased vision of 3 days’ duration. Examination revealed corneal edema, shallow anterior chambers, mid-dilated pupils, and nuclear sclerosis in both eyes, with intraocular pressures of 60 mmHg (OD) and 54 mmHg (OS). B-scan ultrasonography showed no uveal effusion. Despite maximal medical therapy and bilateral laser peripheral iridotomy, intraocular pressure in the right eye remained uncontrolled and necessitated combined phacoemulsification and trabeculectomy. At 1 month, best-corrected visual acuity improved to 20/20 with an intraocular pressure of 14 mmHg without medication. This case highlights escitalopram as a rare precipitant of bilateral angle closure glaucoma in the absence of uveal effusion, requiring tailored surgical intervention.