Serotonin-norepinephrine reuptake inhibitors (SNRIs) are widely used antidepressants with a relatively safe profile. One of the complications associated with this group of drugs is acute angle closure (AAC). The mechanisms linking SNRIs and AAC are complex and may be interlinked with the effects of the drug on the inhibition of serotonin and noradrenaline reuptake, as well as pseudo-anticholinergic effects, dopaminergic effects, and idiosyncratic reactions with the drug molecule in the eye. Individual characteristics, such as polymorphisms of the gene encoding the 2D6 subunit of cytochrome P450, may affect the metabolism of the SNRI; while, the combination with other drugs may lead to an increased risk of iridocorneal angle closure, and may further exacerbate other mechanisms. Improved knowledge of the mechanisms linking SNRIs and AAC and of the risk factors predisposing to patients to AAC will reduce the number of patients affected by this dangerous complication.

Sarcoidosis is a disease that causes noncaseating granulomas in tissues such as the lungs, heart, skin, and eyes. Sarcoidosis is often found through chest x-ray or lesions in the skin and eyes. In over half of patients the disease is detected incidentally by radiographic abnormalities on a routing chest x-ray prior to development of any symptoms. The disease varies in incidence among geographic regions and can also aggregate in families. It is more common in African-Americans who have a lifetime-estimated risk of 2.4 percent compared to a lifetime risk of 0.85 percent in whites. Multiple cases have been reported on sarcoidosis with eye involvement, especially uveitis. We present a healthy 36-year-old male with no past medical who initial presentation of sarcoidosis was uveitis with acute angle closure glaucoma. To our knowledge this is the first reported case of sarcoidosis with this presentation.

A 36-year-old female presented with the complaints of pain, photophobia, redness, and sudden diminution of vision in both the eyes following topiramate for migraine treatment. On examination, there was panuveitis with angle-closure glaucoma in both the eyes with fibrinous exudate with pigments in the anterior chamber of the left eye. B scan revealed increased choroidal thickness in both the eyes. Serial anterior segment optical coherence tomography scans were done in the left eye to demonstrate the gradual resolution of the fibrin material from the anterior chamber. There was complete resolution of inflammation in both eyes following discontinuation of topiramate and treatment with systemic and topical steroids. There was an improvement in visual acuity in the left eye following complicated cataract surgery.