Acute Angle-Closure—A Rare but Vision-Threatening Ocular Adverse Effect of Selective Serotonin Reuptake Inhibitors

Acute angle closure (AAC) is a relatively rare but serious ophthalmological condition in which early diagnosis and intraocular pressure (IOP) -lowering treatment play a key role in prognosis. The aim of this review is to present current understanding of the pathophysiology, symptoms, diagnosis, potential mechanisms as well as management of AAC associated with the use of selective serotonin reuptake inhibitors (SSRIs). In most cases, AAC in individuals receiving SSRIs occurs in the pupillary block mechanism, secondary to SSRI-induced mydriasis. However, SSRIs may also cause uveal effusion and, consequently, iridocorneal angle closure. Other factors such as impaired metabolism and elimination of SSRIs, individual genetic conditions, as well as inhibition of SSRIs metabolism due to the effects of other drugs used may also promote AAC.