Posters

Quetiapine-induced phacomorphic glaucoma

Poster Details

First Author: M. Dowlut UNITED KINGDOM

Co Author(s):    V. Jothi   D. Fraser   S. Kamalarajah              

Abstract Details

Purpose:

Describe rapid progressive bilateral cataracts and phacomorphic glaucoma following initiation of quetiapine in a patient with post-traumatic stress disorder.

Setting:

Royal Victoria Hospital, Belfast

Methods:

We report the case of a forty years old lady who was initiated on treatment for post-traumatic stress disorder with quetiapine by psychiatric team. She had previously had radial keratomies for high myopia. Over a 1-2 months period, she developed rapidly progressive cataracts- her vision changed to hand movement bilaterally. She presented to the acute ophthalmology services with marked worsening vision, severe pain and sickness.

Results:

The patient was found to have bilateral raised intraocular pressure which did not respond to medical management. The intraocular pressure normalised following bilateral yag peripheral iridotomies. She subsequently underwent bilateral lensectomies- this was complicated by the Argentinian flag sign during capsulorrhexis due to high intralenticular pressure.

Conclusions:

The patient made an uneventful post op recovery and achieved bilateral best corrected visual acuity of 6/6. High doses of quetiapine have been shown to induce cataracts in animal studies. The manufacturer recommends biannual screening for cataracts- although this has been shown to be unnecessary in humans. This is the first documented case of rapid onset bilateral cataracts and secondary angle closure glaucoma due to quetiapine.

Financial Disclosure:

NONE