{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:40:05Z","timestamp":1756327205023,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,5]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Herein, we report a case of a woman in late adulthood with bilateral acute angle closure crisis (AACC) secondary to uveal effusions exacerbated by bupropion. Near vision was 20\/20 in both eyes and intraocular pressure (IOP) was 40 and 45\u2009mmHg in the right (OD) and left eye (OS), respectively. We noted bilateral chemosis, uniformly shallow anterior chambers and clear crystalline lenses. Gonioscopy demonstrated 360\u00b0 of appositional closure. Autorefraction demonstrated a 3-diopter myopic shift. B-scan, anterior segment ocular coherence tomography and ultrasound biomicroscopy revealed shallow uveal effusions with anterior rotation of the ciliary body.<\/jats:p>\n               <jats:p>We diagnosed bilateral secondary AACC due to bilateral uveal effusions. After a medication review, we suspected bupropion as a contributing factor and recommended discontinuation. We started atropine, prednisolone and IOP-lowering medications with subsequent normalisation of IOP and resolution of choroidal effusions. A thorough review of medications and medical history is critical when evaluating patients with bilateral AACC.<\/jats:p>","DOI":"10.1136\/bcr-2025-266258","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T23:45:28Z","timestamp":1749599128000},"page":"e266258","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Presumed bupropion-associated acute bilateral angle-closure with uveal effusions"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9510-3747","authenticated-orcid":false,"given":"Nikita","family":"Mokhashi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, The University of Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The University of Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The University of Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The University of Chicago, Chicago, Illinois, USA"},{"name":"Cleveland Clinic Health System, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"2025082713220206000_18.6.e266258.1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.5005\/jp-journals-10078-1261","article-title":"Drug-induced acute angle-closure glaucoma: a review","volume":"13","author":"Yang","year":"2019","journal-title":"J Curr Glaucoma Pract"},{"key":"2025082713220206000_18.6.e266258.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.86.2.238"},{"key":"2025082713220206000_18.6.e266258.3","first-page":"271","article-title":"Review of sulfonamide-induced acute myopia and acute bilateral angle-closure glaucoma","volume":"8","author":"Panday","year":"2007","journal-title":"Compr Ophthalmol Update"},{"key":"2025082713220206000_18.6.e266258.4","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.130.1.120"},{"key":"2025082713220206000_18.6.e266258.5","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1001\/jamaophthalmol.2015.2180","article-title":"Risk of angle-closure glaucoma with bupropion and topiramate","volume":"133","author":"Symes","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"2025082713220206000_18.6.e266258.6","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/6578750","article-title":"The Pathogenesis and treatment of complications in nanophthalmos","volume":"2020","author":"Yang","year":"2020","journal-title":"J Ophthalmol"},{"key":"2025082713220206000_18.6.e266258.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12886-019-1230-y","article-title":"Angiographic features of drug-induced bilateral angle closure and transient myopia with ciliochoroidal effusion","volume":"19","author":"Kang","year":"2019","journal-title":"BMC Ophthalmol"},{"key":"2025082713220206000_18.6.e266258.8","doi-asserted-by":"crossref","first-page":"e40","DOI":"10.1097\/IJG.0000000000000836","article-title":"Acute angle-closure glaucoma associated with aripiprazole in the setting of plateau iris configuration","volume":"27","author":"Shen","year":"2018","journal-title":"J Glaucoma"},{"key":"2025082713220206000_18.6.e266258.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2007.123943"},{"key":"2025082713220206000_18.6.e266258.10","doi-asserted-by":"crossref","unstructured":"Durai I , Mohan Dhavalikar M , Anand CP , et al . 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