A Sight-Threatening Side Effect of Brimonidine 0.2%: A Case Report

A lady in her 60s with primary open angle glaucoma was on latanoprost, dorzolamide/timolol combination and brimonidine drops for approximately three years. She presented to the eye casualty with a four-month history of worsening bilateral red, painful eyes with reduced vision. On examination, she had very poor vision, florid granulomatous anterior uveitis with posterior synechiae, mutton-fat keratic precipitates, and hypopyon in the left eye. Her intraocular pressures were very high despite her topical glaucoma medications. She also had bilateral follicular conjunctivitis. Investigations for systemic or infectious causes of anterior uveitis were negative.