Introduction: Psychotropic agents may frequently be associated with ocular adverse effects, which include angle-closure glaucoma. We report a case of pseudoexfoliation glaucoma in which intraocular pressure (IOP) increased within hours after carbamazepine and gabapentin intake, with no observable evidence of any angle closure.
Case report: A 67-year-old woman with pseudoexfoliation glaucoma presented with high IOP in her right eye after carbamazepine and gabapentin intake. To investigate which psychotropic medicine was the cause of this fluctuation, the patient was called for 2 subsequent visits and the order of the medicines she took was changed in each examination. Baseline IOP was recorded in each examination, and the IOP was monitored hourly after the intake of medicines. Baseline and hourly Pentacam measurements were also made to demonstrate changes in anterior segment parameters.
Discussion: Gabapentin and carbamazepine resulted in deepening of the anterior chamber, widening of the iridocorneal angle, and mild pupillary dilation in 2 visits. Carbamazepine was associated with a significant increase in IOP independent of gabapentin use. The absence of angle closure and plateau iris configuration suggested other mechanisms that might be related to high IOP after carbamazepine intake.
Conclusion: This is the first reported case of a large increase in IOP within hours after carbamazepine and gabapentin intake in a pseudoexfoliative eye.