Diagnosis of acromegaly following acute glaucoma: A rare case report

Abstract Glaucoma is rarely detected after the diagnosis of acromegaly. The ophthalmologic symptoms of visual field defects and pale optic disks are overlapping for both glaucoma and acromegaly. Here, we describe the case of a 25-year-old male patient, freshly diagnosed with acute glaucoma following complaints of painful blurring of vision. He did not have any other classical symptoms or complications of acromegaly. On endocrinology evaluation, he had acromegaloid features in addition to increased intraocular pressure and pale optic disks. Hormonal evaluation showed 5-times elevated insulin like growth factor 1 for his age without any hyperprolactinemia or hypopituitarism. Contrast-enhanced magnetic resonance imaging of sella showed pituitary macroadenoma with suprasellar and right parasellar extension. Perimetry ruled out any visual field defects. He underwent trans-nasal trans-sphenoidal endoscopic pituitary surgery for excision of somatotropinoma. This represents a rare case of acromegaly with initial presentation as acute glaucoma. It also reinforces the importance of meticulous clinical examination in diagnosing rare endocrinopathy in today’s era.