Abstract
In this case report, we describe a rare case of acute angle closure in an 18-year-old African-American female, attributed to plateau iris. The patient had no significant medical or ocular history and presented with high right-eye pressure, headache, and blurred vision. Ocular examination revealed findings consistent with acute angle closure, with gonioscopy confirming superior iris insertion anterior to Schwalbe's line and a "double hump" sign. Ultrasound biomicroscopy confirmed plateau iris. Treatment involved pharmacological management and bilateral peripheral laser iridoplasty. This case underscores the importance of considering plateau iris syndrome in the differential diagnosis of acute angle closure, even in younger patients, and highlights the role of early diagnosis and appropriate intervention in preventing vision loss.