Acute Angle-Closure Glaucoma and Paroxetine

Letter to the Editor

Sir: Acute angle-closure glaucoma has been linked to use of
tricyclic antidepressants and monoamine oxidase inhibitors.
Susceptible patients are described as those with a history of
angle-closure, age greater than 40 years, dilated pupils at initial
examination, a personal or family history of glaucoma, and a
history of ocular symptoms (visual abnormalities and/or eye
pain). While there is some debate about the role of antidepressant
medication in exacerbating or causing glaucoma, clinicians
have advocated use of serotonin selective reuptake inhibitors (SSRIs) in treatment of high-risk patients. We report a case of
acute angle-closure glaucoma related to paroxetine use in a patient
with mydriasis on examination prior to treatment but who
had no personal or family history of glaucoma.