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October 1986

Angle Closure Glaucoma and Acute Hyperglycemia

Arch Ophthalmol. 1986;104(10):1434. doi:10.1001/archopht.1986.01050220028006

To the Editor.  —The osmotic effects of acute hyperglycemia are becoming better understood. Although many such effects have been described, there has been little mention of diabetic hyperglycemia precipitating angle closure. We have recently seen such an occurrence.

Report of a Case.  —A 59-year-old man with a 15-year history of insulin-dependent diabetes mellitus and a six-year history of open angle glaucoma was seen by us in August 1985. His best corrected visual acuity was 20/60 OD and 20/40 OS. The applanation tensions were 22 mm Hg OU, while he was being treated with 4% topical pilocarpine hydrochloride, 0.5% timolol maleate, and 0.1% dipivefrin hydrochloride. The anterior chambers were of normal depth, and gonioscopy showed the angles to be open to at least the full trabecular meshwork for 360° in both eyes. Neither angle was thought to be closable. The optic discs had a cup-to-disc ratio of 0.8, and both fundi