Increased intraocular pressure as the first presenting sign of Miller Fisher syndrome

This is the first case report of open-angle glaucoma with acute IOP elevation as the first symptom of Miller Fisher syndrome. The mechanism may be due to damage to the trabecular meshwork or maintenance of intraocular pressure, which results in acute intraocular pressure elevation in patients with preexisting open-angle glaucoma when the pupil dilates. Clinicians should be aware of the autonomic dysfunction caused by MFS, dilated pupils, and sudden increases in intraocular pressure, regardless of angle status.