We report the case of congenital ectropion uveae in a 10-year-old boy with intractable unilateral glaucoma but no systemic association. Glaucoma in congenital ectropion uveae is often poorly responsive to medial therapy and requires surgical intervention. Satisfactory results are possible if diagnosis is established early and timely surgery performed, as was the case in our patient.
Pigmentary glaucoma (PG) a type of secondary open angle glaucoma is characterized by classic diagnostic triad of Krukenberg's spindle; mid peripheral iris transillumination defects and dense Trabecular pigmentation. Treatment consists of medical management followed by laser iridotomy/ laser trabeculoplasty and trabeculectomy in recalcitrant cases; trabeculectomy is challenging with a higher risk of bleb failure and Hypotony Maculopathy.We report the case of a 43-year-old one-eyed male with BCVA 6/9 OS (log MAR 0.2); intraocular pressure (IOP) 34mmHg, oedematous cornea, prominent Krukenberg spindle and a very prominent Eggers line. He had advanced glaucomatous cupping (CDR 0.7:1); gonioscopy showed widely open angles, with "queer" iris configuration, and heavily pigmented PTM (Gd IV) with advanced damage on perimetry. As patient couldn't be weaned off systemic anti-glaucoma medications, trabeculectomy with antifibrotic augmentation was done. The surgery was uneventful and resulted in stabilizing IOP at 12-14 mmHg over a 6 month follow up till date.
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