Paradox in the eyes: Acetazolamide-induced bilateral acute secondary angle closure glaucoma and review of literature

Drug induced bilateral acute angle closure is an ophthalmic emergency that can lead to vision threatening sequelae if not recognized and treated promptly. Acetazolamide is a Sulphonamide derivative implicated in this peculiar phenomenon. Acute bilateral angle closure happens due to an idiosyncratic mechanism. This drug is widely employed in various specialties apart from Ophthalmology. We report a case of bilateral acute angle closure crisis following administration of oral Acetazolamide after a retinal detachment surgery. Though this is a well-recognized side effect, the diagnosis was challenging due to the confounding effect of scleral buckle, leading to unilateral choroidal effusion.