Severe malaria-associated secondary glaucoma: a case report

Abstract

Introduction: Malaria remains a significant global health challenge, particularly in endemic regions, with severe complications affecting multiple organ systems. Ocular manifestations, though less common, can include vision-threatening conditions such as secondary glaucoma. This report describes a rare case of secondary acute angle-closure glaucoma developing in the context of severe Plasmodium falciparum malaria.

Case Presentation: A 55-year-old Ethiopian woman presented to the emergency room with a 5-day history of high-grade intermittent fever, headache, and joint pain. Laboratory findings confirmed falciparum malaria, with marked thrombocytopenia. Despite initial antimalarial therapy, she developed blurred vision and ocular redness. Ophthalmologic evaluation revealed shallow anterior chambers, mid-dilated pupils, and significantly elevated intraocular pressure. She received topical glaucoma treatment, resulting in symptomatic relief and intraocular pressure reduction. Her platelet count improved during hospitalization, and she was discharged in stable condition.

Conclusion: This case underscores the importance of prompt recognition of ocular complications in severe malaria. Secondary glaucoma, although rare, can develop rapidly and requires timely ophthalmologic intervention to prevent irreversible vision loss. Awareness of such associations is vital for the comprehensive management of malaria patients presenting with visual symptoms.