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Bilateral acute angle-closure is a rare occurrence. When the central anterior chambers are shallow, it is often associated with systemic disease. We present 2 patients with atypical bilateral acute angle-closure as the presentation of systemic lymphoma. In these patients, angle closure may be caused by a uveal effusion or swelling of the ciliary body. If an atypical bilateral acute angle-closure attack cannot be attributed to a drug reaction or a bilateral iatrogenic cause, the patient should be evaluated for an associated systemic disease. In some patients, the acute angle-closure cannot be fully resolved until the underlying disease is treated. This report discusses the spectrum of presentations and the various diseases that have been associated with bilateral acute angle-closure.