Published Paper Details:

Hemodialysis can affect intraocular pressure (IOP) in patients with end-stage renal disease, but the underlying mechanisms are poorly elucidated. We present the clinical case of an ocular hypertonic crisis in a hemodialysis patient and discuss its implications for the management of hemodialysis patients. Observation: After a hemodialysis session, a 36-year-old man with end-stage renal disease and type I diabetes developed a more pronounced ocular hypertonic crisis in his right eye. Decreased visual acuity, ocular pain, nausea and headache were among the symptoms. Ophthalmological examination revealed bilaterally elevated intraocular pressure, corneal edema and a narrow anterior chamber, all more marked on the right side. After general and local hypotonic treatment, clinical signs improved, and gonioscopy revealed a closed angle in the right eye and a narrow angle in the left eye . Discussion: Osmotic fluctuations, variations in the iridocorneal angle and accumulation of toxic substances may be mechanisms contributing to increased intraocular pressure (IOP) in hemodialysis patients. Management of intraocular pressure (IOP) in these patients is crucial to avoid serious ocular complications. For high-risk patients, preventive measures such as peripheral laser iridotomy may be considered.