Bilateral angle closure glaucoma: an unusual presentation of Vogt-Koyanagi-Harada syndrome

Editor,—Vogt–Koyanagi–Harada (VKH) syndrome is a bilateral, diffuse, granulomatous uveitis associated with exudative retinal detachment and central nervous system, auditory, and dermatological involvement.1 It is a common cause of uveitis in Japan and, to a lesser extent, in parts of Latin America and the USA. We report a case of VKH syndrome with an unusual presentation of bilateral secondary acute angle closure glaucoma (SAACG). Because of the rarity of this presentation of VKH syndrome (this being the first report, to our knowledge, of such a presentation outside the USA and Japan) we initially had difficulties in diagnosing and treating it in the optimal way. We thus stress the importance of clinicians being aware of such a VKH syndrome presentation, especially in those parts of the world where the disease is rare. ### CASE REPORT A 20-year-old white woman presented in April 1996 complaining of sudden onset of blurred vision in both of her eyes. Her past medical history and her family history were unremarkable. Visual acuity was 6/24 in both eyes, improving to 6/12 with a pinhole. The corneas were slightly …