A 27-year-old woman presented with acute eye pain, vision loss and significantly increased intraocular pressure (IOP). Clinical findings included conjunctival congestion, corneal edema, moderately deep anterior chambers, and absence of keratic precipitates or aqueous flare. Ultrasound biomicroscopy revealed ciliary body detachment and optical coherence tomography revealed multiple serous retinal detachments. She was initially diagnosed with primary angle-closure glaucoma, later revised diagnosis of secondary acute angle-closure glaucoma caused by Vogt-Koyanagi-Harada (VKH) syndrome. She was treated with intravenous methylprednisolone pulse therapy, topical corticosteroids, mydriatic agents, and IOP-lowering medications. Visual acuity and intraocular pressure gradually improved, the subretinal fluid was completely corrected. VKH syndrome rarely presents with acute angle-closure glaucoma as the initial presentation. Early anti-inflammatory treatment is key to reversing angle closure and retinal pathology.