Clinical Case 1
Leyan Shalabi, D.O.
Julie Martino, M.D.
Review of Systems
Constitutional: Negative for chills and fever.
Vitals: BP: 116/69, P 70, T 98.1F, RR 13, SpO2 100%
Past Medical History
Past Surgical History
Basic Metabolic Panel
Anion Gap: 9
CTA Head and Neck W WO Contrast:
Ophthalmology and Neurology consults placed
So... what is causing these headaches, vision changes, and now hemodynamic instability?
Click to view answer
Bilateral acute-angle closure glaucoma
Culprit? .... Topiramate
Hindsight is 20/20.
Imaging & Interventions
Diagnosing Acute-Angle Closure Glaucoma
Disposition and Treatment
Immediate ophthalmology consultation ASAP!
Don't turn a blind eye- give adequate pain control and antiemetics as needed.
Definitive Treatment & Disposition