{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T15:43:53Z","timestamp":1766504633369},"reference-count":9,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Acute angle closure glaucoma (AACG) is an ophthalmological emergency, and can lead to the devastating consequence of permanent vision loss if not detected and treated promptly. We present a case of an atypical presentation of unilateral AACG on post operative day (POD) 1, after a prolonged operation under general anaesthesia (GA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>A 65-year-old female underwent a 16 hour long operation for breast cancer and developed an altered mental status with a left fixed dilated pupil on POD 1. She was intubated to secure her airway in view of a depressed consciousness level and admitted to the intensive care unit. Initial blood investigations and brain imaging were unremarkable. On subsequent review by the ophthalmologist, a raised intraocular pressure was noted and she was diagnosed with acute angle closure glaucoma. She was promptly started on intravenous acetazolamide and pressure-lowering ophthalmic drops. Her intraocular pressure normalized in the next 24 hours with improvement in her mental status to baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>AACG needs to be consistently thought of as one of the top differentials in any post-operative patient with eye discomfort or abnormal ocular signs on examination. A referral to the ophthalmologist should be made promptly once AACG is suspected.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2478\/jccm-2023-0016","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T09:53:31Z","timestamp":1691661211000},"page":"187-191","source":"Crossref","is-referenced-by-count":1,"title":["Post-Operative Delirium Masking Acute Angle Closure Glaucoma"],"prefix":"10.2478","volume":"9","author":[{"given":"Zariel Jiaying","family":"Sim","sequence":"first","affiliation":[{"name":"Singhealth, Singapore , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing","family":"Jieyin","sequence":"additional","affiliation":[{"name":"Singapore General Hospital, Singapore , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thangavelautham","family":"Suhitharan","sequence":"additional","affiliation":[{"name":"Singapore General Hospital, Singapore , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2023,7,31]]},"reference":[{"key":"2024042711433869458_j_jccm-2023-0016_ref_001","unstructured":"Khazaeni B, Khazaeni L. Acute Closed Angle Glaucoma [Internet]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2022."},{"key":"2024042711433869458_j_jccm-2023-0016_ref_002","doi-asserted-by":"crossref","unstructured":"McMonnies CW. Glaucoma history and risk factors. J Optom. 2017;10(2):71\u20138.","DOI":"10.1016\/j.optom.2016.02.003"},{"key":"2024042711433869458_j_jccm-2023-0016_ref_003","doi-asserted-by":"crossref","unstructured":"Yang MC, Lin KY. Drug-induced Acute Angle-closure Glaucoma: A Review. J Curr glaucoma Pract. 2019;13(3):104\u20139.","DOI":"10.5005\/jp-journals-10078-1261"},{"key":"2024042711433869458_j_jccm-2023-0016_ref_004","doi-asserted-by":"crossref","unstructured":"Tasbihgou SR, Absalom AR. Postoperative neurocognitive disorders. Korean J Anesthesiol. 2021 Feb;74(1):15\u201322.","DOI":"10.4097\/kja.20294"},{"key":"2024042711433869458_j_jccm-2023-0016_ref_005","doi-asserted-by":"crossref","unstructured":"Hughes CG, Boncyk CS, Culley DJ, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention. Anesth Analg. 2020 Jun;130(6):1572\u201390.","DOI":"10.1213\/ANE.0000000000004641"},{"key":"2024042711433869458_j_jccm-2023-0016_ref_006","doi-asserted-by":"crossref","unstructured":"O\u2019Gara BP, Gao L, Marcantonio ER, et al. Sleep, Pain, and Cognition: Modifiable Targets for Optimal Perioperative Brain Health. Anesthesiology. 2021 Dec;135(6):1132\u201352.","DOI":"10.1097\/ALN.0000000000004046"},{"key":"2024042711433869458_j_jccm-2023-0016_ref_007","doi-asserted-by":"crossref","unstructured":"Clegg A, Young JB. Which medications to avoid in people at risk of delirium: a systematic review. Age Ageing. 2011 Jan;40(1):23\u20139.","DOI":"10.1093\/ageing\/afq140"},{"key":"2024042711433869458_j_jccm-2023-0016_ref_008","unstructured":"Lotery AJ, Frazer DG. Iatrogenic acute angle closure glaucoma masked by general anaesthesia and intensive care. Ulster Med J. 1995 Oct;64(2):178\u201380."},{"key":"2024042711433869458_j_jccm-2023-0016_ref_009","doi-asserted-by":"crossref","unstructured":"Lentschener C, Ghimouz A, Bonnichon P, et al. Acute postoperative glaucoma after nonocular surgery remains a diagnostic challenge. Anesth Analg. 2002 Apr;94(4):1034\u20135, table of contents.","DOI":"10.1097\/00000539-200204000-00049"}],"container-title":["The Journal of Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.sciendo.com\/pdf\/10.2478\/jccm-2023-0016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T11:43:48Z","timestamp":1714218228000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.sciendo.com\/article\/10.2478\/jccm-2023-0016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":9,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,7,31]]},"published-print":{"date-parts":[[2023,7,1]]}},"alternative-id":["10.2478\/jccm-2023-0016"],"URL":"https:\/\/doi.org\/10.2478\/jccm-2023-0016","relation":{},"ISSN":["2393-1817"],"issn-type":[{"value":"2393-1817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,1]]}}}