Symptomatic intraocular pressure dysregulation during clopidogrel exposure after patent foramen ovale closure in a patient with ocular hypertension and angle crowding: a Case Report.

Clopidogrel is widely used after structural heart interventions, but symptomatic intraocular pressure (IOP) abnormalities without clinically evident hemorrhage are rarely reported. We describe a 52-year-old woman who developed recurrent ocular discomfort, eye pain, and blurred vision after percutaneous patent foramen ovale closure followed by clopidogrel-containing antiplatelet therapy. Baseline pre-exposure assessment showed ocular hypertension with angle crowding features but no definite glaucomatous structural or functional damage. Symptoms improved after clopidogrel withdrawal and recurred after re-administration. During recurrent symptomatic exposure, 24-h IOP monitoring showed marked peak elevation and diurnal fluctuation in both eyes. Baseline pre-exposure IOP measurements were available, but baseline 24-h IOP monitoring was not performed; therefore, worsening relative to the patient's baseline diurnal pattern could not be confirmed. Formal gonioscopy and symptomatic-phase angle reassessment were unavailable, and intermittent angle closure could not be excluded. This case represents a dechallenge-rechallenge-supported temporal association and hypothesis-generating pharmacovigilance signal rather than definitive evidence of a clopidogrel-induced effect.