DR.SATISH CHADHA

DR. RAMINDER SINGH

Abstract

A 25-year-old lady reported to A/E with sudden loss of vision, no pain /systemic symptoms, h/o treatment for IIH.

VA HM in BE, she could see her phone held closer suggesting myopia. Only Limited/essential eye equipment available in late hours in A/E.Slit lamp revealed shallow AC (VH grade 1-2), IOP fluctuated 30- 48 mm of Hg in BE (Goldman tonometer). Fundus reveled forward displacement of Ora in 360 quadrants giving suspicion of Ciliochoroidal effusion.IOP lowering medication, cycloplegics given,Topiramate stoped.Next day in eye clinic VA improved with -5 D to 6/6 BE, B-scan revealed fluid in the suprachoroidal space,OCT macula revealed undulating lines at the level of RPE, and peripheral effusion on fundus examination and photos.Responded well to treatment & improvement in 2 weeks. In absence of multimodal imaging in A/E,high index of suspicion and careful clinical examination helps to diagnose & treat bilateral AACG secondary to ciliochoroidal effusion induced by Topiramate.