Unilateral symptomatic elevation of intraocular pressure and prevention using a hyperosmotic agent during hemodialysis.

BACKGROUND We report on a patient with unilateral elevation of intraocular pressure during hemodialysis. CASE A 60-year-old man with unilateral exfoliative material complained of severe pain in the right eye during hemodialysis. OBSERVATIONS The intraocular pressure (IOP) in the patient's right eye was 56 mm Hg, and increased repeatedly during hemodialysis. The IOP in his left eye remained within a normal range. Trabeculectomy failed to reduce the elevation of IOP in the right eye. Changes in plasma osmotic pressure during hemodialysis were marked when the IOP was elevated. The administration of a hyperosmotic agent prevented the elevation of IOP during hemodialysis. CONCLUSIONS Physicians should be aware that elevation of IOP in patients with eyes with exfoliative material may occur during hemodialysis even after trabeculectomy. This can be prevented by administering a hyperosmotic agent during hemodialysis.