AOR
Archives of Ophthalmological Research

The Archives of Ophthalmological Research aims to publish issues related to publish articles of the highest scientific and clinical value at an international level, and accepts articles on these topics. The target audience of the journal included specialists and physicians working in ophthalmology, and other health professionals interested in these fields.

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Case Report
Acute angle-closure glaucoma following repeated periocular botulinum toxin injection for blepharospasm: a case report
Abstract
Acute angle closure (AAC) is an ophthalmic emergency characterized by sudden elevation of intraocular pressure due to obstruction of aqueous humor outflow. Several systemic and topical medications, including Botulinum toxin, have been implicated in precipitating AAC in susceptible individuals. Botulinum toxin may induce mydriasis through inhibition of acetylcholine release at parasympathetic nerve terminals. We report the case of a 52-year-old woman who developed Botulinum toxin-associated AAC following repeated periocular Botulinum toxin injections for blepharospasm. The patient presented with ocular pain, redness, and blurred vision in the right eye three days after injection. Ophthalmic examination revealed elevated intraocular pressure, corneal edema, shallow anterior chambers, and closed iridocorneal angles on gonioscopy. Additional examination demonstrated hyperopia in the fellow eye, bilateral occludable angles, iris bombe configuration, and relative mid-dilation of the affected pupil, suggesting a pupillary block mechanism. After initial medical treatment, bilateral neodymium (Nd) laser peripheral iridotomy was successfully performed, resulting in normalization of intraocular pressure without recurrence during approximately 12 months of follow-up. Although rare, Botulinum toxin-associated AAC should be considered in patients with occludable angles and other anatomical risk factors. Careful anterior chamber angle assessment before periocular Botulinum toxin administration may help identify patients at risk and prevent vision-threatening complications.

Keywords : Acute angle-closure glaucoma, Botulinum toxin, blepharospasm, laser peripheral iridotomy

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Article available in :
Volume 3, Issue 2, 2026
Page : 31-33
https://doi.org/10.51271/AOR-0051
Article Information
Received : 28 May 2026
Accepted : 29 Haz 2026
Published : 30 Haz 2026
Corresponding Author :

Yaşar Ölmez: Department of Ophthalmology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkiye

[email protected]
Citation : Ölmez Y, Dursun E. Acute angle closure following repeated periocular Botulinum toxin injection for blepharospasm: a case report. Arch Ophthalmol Res. 2026;3(2):32-34.

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