Anterior ischemic optic neuropathy in acute angle closure attack

A female aged 56 years with a positive history of diabetes mellitus presented with severe headache and eye pain. On examination of her right eye, symptoms of acute angle closure attack such as congestion, corneal edema, and increased intraocular pressure were revealed. Fundus examination depicted anterior ischemic optic neuropathy (AION) with pallid disc edema. Treatment involved IV mannitol, topical drugs, and laser peripheral iridotomy. Her visual acuity improved accompanied by a noticeable contraction of her visual field. This case emphasizes the importance of early identification and treatment, highlighting the peculiar association between acute primary angle closure and AION.