Unilateral acute angle closure glaucoma

Abstract

SUMMARYA 52-year-old gentleman presented with 1-week history of severe right-sided headache associated with reduced vision in his right, amblyopic eye. Examination revealed raised intraocular pressure at 64 mm Hg. The anterior chamber (AC) was shallow and there was a dense cataract with no red reflex or fundal view. The contralateral eye had a deep anterior chamber with normal pressure and a clear lens. He was treated initially for acute angle closure glaucoma. The anterior chamber remained shallow and the intraocular pressure uncontrolled, despite maximum medical therapy. Owing to the absent fundal view and unilateral AC shallowing, further imaging was performed and a choroidal mass was found to be responsible for anterior displacement of the lens and shallowing of the angle. He went on to have an enucleation of the right eye, and histological examination confirmed the diagnosis of choroidal melanoma. BACKGROUND

Late onset pupillary block glaucoma following phacoemulsification with posterior chamber intraocular lens implantation

“…Hence, masquerade has also kept a possibility. 6 The key finding was that despite the flat AC, the IOL appeared to be in its normal position clinically. This was supported by UBM findings which showed IOL in normal position whereas iris was pushed forward to the back of the cornea, grossly enlarging the posterior chamber (Figure 2(a)).…”

Could acute angle closure glaucoma be an indicator of something more ominous?

“…Choroidal melanomas are the most common type of primary intraocular tumor in adults, but they are still rare with only 6-8 cases per million population. 1,5 It is commonly found in Caucasian females in the age group of 50-60 years. In contrast, our patient was a 71 year old Indian lady.…”

“…In contrast, our patient was a 71 year old Indian lady. 5 Secondary elevation of intraocular pressure (IOP) occurs in 5% of intra ocular tumors and in 2% of choroidal melanomas. 6 Tumors of the posterior segment are more likely to cause glaucoma.…”

“…Another similar case was reported by Tan where the IOP continued to be high after peripheral iridotomy and ultrasonography revealed choroidal melanoma. 5 In scenarios where the IOP doesn't reduce following iridotomy, Radcliffe cautions us to consider other causes of angle closure. 8 There are multiple such reports in literature highlighting the need for complete ocular examination following treatment of a case that presents as angle closure crisis.…”

Calpain: a molecule to induce AIF-mediated necroptosis in RGC-5 following elevated hydrostatic pressure

“…In our study, we chose three pressure values (100 mmHg, 30 mmHg and 60 mmHg) to detect possible levels in necrosis after injury. Among these three pressure values, 100 mmHg represented acute glaucoma (high pressure), 30 mmHg represented low pressure in glaucoma [ 40 ] and 60 mmHg was a maximum pressure value in human IOP [ 42 ]. The results indicated that the number of PI positive cells increased first and then decreased followed by the time passage in 100 mmHg and 60 mmHg.…”