Acute angle closure in the setting of high axial myopia: A case report

Acute angle closure is common in hyperopic eyes but uncommon in myopic eyes. Here, we report a case of angle closure attack in a 59-year-old female patient with high axial myopia. The patient presented without underlying medical history or drug history with marked congestion and progressively blurred vision in her right eye (RE) for 1 week. Initial intraocular pressure (IOP) was 40 mmHg in the RE and 19 mmHg in the left eye. Slit lamp examination revealed a very shallow anterior chamber in both eyes and marked corneal microcytic edema in the RE. Acute angle closure of the RE was diagnosed. Conservative IOP-lowering management followed by laser iridotomy was effective in managing acute high IOP crisis; however, early cataract extraction was necessary for long-term IOP control. Clinicians should be mindful of the possibility of acute angle closure even in highly axially myopic eyes.