DOI: https://doi.org/10.36347/sjmcr.2026.v14i02.001

Pages: 184-186

Background: Acute angle-closure glaucoma [AACG] is a vision-threatening ophthalmologic emergency caused by rapid obstruction of aqueous humor outflow with sudden elevation of intraocular pressure [IOP]. Typical symptoms include severe ocular pain, red eye, blurred vision/halos, headache, and nausea/vomiting. [1–3] Although AACG is often related to anatomically narrow angles, it can also be precipitated by drugs, particularly agents capable of inducing mydriasis or affecting iris–lens dynamics in predisposed eyes. [4] Nebulized anticholinergic bronchodilators such as ipratropium bromide have been linked to rare cases of AACG, especially when aerosol medication contacts the ocular surface due to mask leakage. [5–8] Case Presentation: An 80-year-old female with asthma and hypertension presented with an asthma attack. Vital signs were stable [BP 160/70 mmHg, pulse 76/min, SpO₂ 97%] with accessory muscle use and diffuse wheezing. Nebulized salbutamol and ipratropium bromide were administered via mask. During treatment, she developed acute right eye pain and blurred vision. Examination revealed conjunctival hyperemia and an irregular, non-reactive right pupil. Ophthalmologic consultation confirmed narrow angles with elevated IOP, consistent with AACG. The patient was referred for definitive ophthalmologic management. Conclusion: AACG is a rare but serious complication of nebulized bronchodilator therapy. Preventive measures such as ensuring a tight-fitting mask or using a mouthpiece can reduce ocular exposure. [6–9] Early recognition and urgent IOP-lowering management with ophthalmology involvement are essential to prevent permanent vision loss. [1–3,10]