Bilateral acute myopia and angle closure glaucoma induced by Ma-huang (Ephedra): A case report

RATIONALE: Cases of bilateral acute angle closure have been reported after use of various drugs. PATIENT CONCERNS: A 52-year-old woman visited the emergency room and complained of acute bilateral ocular pain and decreased vision accompanied by headache, nausea, and vomiting. One day before, she had started a herbal medicine containing Ma-huang for weight loss. On examinations, myopic shift, edematous cornea, increased intraocular pressure, shallow anterior chamber, and thickened choroid on both eyes were observed. DIAGNOSES: Angle closure glaucoma induced by drug (Ma-huang). INTERVENTIONS: To promptly quit the offending drug and apply ocular hypotensives and cycloplegics. OUTCOMES: Her symptoms and signs were relieved after antiglaucoma medications and no significant recurrence has been occurred. LESSONS: Physicians prescribing weight loss medications containing Ma-huang must be aware of the potentially sight-threatening adverse effect of bilateral acute angle closure.