Acute angle-closure glaucoma in a patient with miller fisher syndrome without pupillary dysfunction.

PURPOSE: To report a case of an angle-closure glaucoma in a patient with Miller Fisher syndrome (MFS) without pupillary dysfunction.

METHODS: We present a case report of a 75-year-old male presenting with total ophthalmoplegia, complete bilateral ptosis, and gait disturbance. He was diagnosed with MFS without pupillary dysfunction, which precipitated unilateral acute angle-closure glaucoma (AACG) due to complete lid ptosis.

RESULTS: The initial ocular examination revealed hand motion in the right eye. Intraocular pressure, as assessed by Goldmann applanation tonometry, was 50 mm Hg, and gonioscopic findings revealed a closed angle on the right eye. After maximal tolerated medical therapy, laser peripheral iridotomy was performed. The unilateral AACG with MFS resolved without further incident.

CONCLUSIONS: This is the first reported case of a patient with MFS without autonomic dysfunction and AACG. We believe that pupillary dysfunction or lid ptosis due to neurological disorders may increase the possibility of AACG.