Glaucoma associated with sinusitis: A case report

William A. Kantrales, Martin P. Wegman, Jennifer Chapman, Nawzad Jacksi
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Abstract

Background

Acute rhinosinusitis is frequently diagnosed in emergency departments and primary care settings across the United States. Most cases are allergic or viral in etiology and resolve with supportive measures. Complications are rare, but when occurring are typically a result of bacterial sinusitis, extension of infection, and cerebral venous thrombosis. We describe a case of acute rhinosinusitis with co-existing acute angle closure glaucoma.

Case report

A 42-year-old female with history of headache disorder presented to the emergency department with the chief complaint of a left-sided headache, blurry vision, aural fullness, malaise and fatigue. She was suspected to have a viral syndrome with associated headache of non-emergent etiology and was discharged after partial improvement in response to a conventional analgesic regimen. She returned with worsening symptoms and was subsequently discovered to have acute angle closure glaucoma (AACG) by tonometry and sinusitis by Computed Tomography. The patient's intraocular pressures improved with standard AACG therapies. She was continued on these medications at discharge in combination with amoxicillin for presumed bacterial sinusitis.

Why should an emergency physician be aware of this?

Sinusitis and AACG have overlapping symptoms and can co-occur. Thus, AACG should be considered in a patient that presents with symptoms suggestive of sinusitis with an associated ocular complaint. Further study should seek to measure the relationship between these two diseases and investigate potential causal links.

Categories

Emergency Medicine, Ophthalmology, Otolaryngology.

Keywords

Case report, Sinusitis, Glaucoma, Acute angle closure glaucoma, Blurry vision.

Disclaimer

This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.

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与鼻窦炎相关的青光眼:病例报告
背景美国各地的急诊科和初级保健机构经常诊断出急性鼻炎。大多数病例的病因是过敏或病毒,采取支持性措施后即可缓解。并发症很少见,但一旦发生,通常是细菌性鼻窦炎、感染扩展和脑静脉血栓形成的结果。我们描述了一例急性鼻窦炎并发急性闭角型青光眼的病例。病例报告 一位 42 岁的女性患者因主诉左侧头痛、视力模糊、耳部饱胀、乏力和疲劳到急诊科就诊,有头痛病史。她被怀疑患有病毒性综合征,并伴有非突发病因的头痛,在接受常规镇痛治疗后症状部分好转,随后出院。她因症状加重而再次就诊,随后通过眼压测量发现她患有急性闭角型青光眼(AACG),通过计算机断层扫描发现她患有鼻窦炎。采用标准的急性闭角型青光眼疗法后,患者的眼压有所改善。出院时,她继续服用这些药物,同时服用阿莫西林治疗假定的细菌性鼻窦炎。因此,当患者出现鼻窦炎症状并伴有眼部不适时,应考虑 AACG。关键词病例报告鼻窦炎青光眼急性闭角型青光眼视力模糊免责声明本研究得到了 HCA Healthcare 和/或 HCA Healthcare 附属机构的支持(全部或部分)。本出版物中表达的观点仅代表作者本人,并不一定代表 HCA Healthcare 或其任何附属机构的官方观点。
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来源期刊
JEM reports
JEM reports Emergency Medicine
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