Modification of Dialysis for Management of Elevated Intraocular Pressure: A Case Report

In this report, we discuss the case of a chronically ill 74-year-old male who developed severe intraocular pressure (IOP) elevations following dialysis treatments after intraocular lens (IOL) exchange. He presented with elevated IOP at 1-week post-op, which was treated topically and orally with success. However, he soon experienced recurrent episodes of severe IOP spikes in the 30–50 mmHg range accompanied by severe pain, nausea, and vomiting. After multiple such episodes, the patient was admitted to the hospital for close observation, where it was found that his IOP severely increased soon after dialysis. After discussion with nephrology, increasing the duration and weekly number of dialysis sessions led to significantly improved IOPs. The patient has done well since that time and was able to return to normal dialysis length and schedule without issue. This case sheds light on possible IOP elevations post dialysis, especially if aqueous outflow is acutely impeded.