ABSTRACT

This case report presents the clinical presentation and management of a 68-year-old male with chronic angle closure glaucoma. Upon examination, the right eye (OD) exhibited a significant decline in visual acuity to 1/300. Findings included conjunctival congestion (CVI +) and absence of posterior conjunctival vessel congestion (PCVI -), corneal opacification and edema, shallow anterior chamber, midriasis of the pupil, and absence of direct and consensual light reflexes (−). Additionally, lens opacification and chemosis (+) were observed. Conversely, the left eye (OS) had a visual acuity of 6/30 with an intraocular pressure (IOP) of 6/15. Similar to the right eye, it displayed corneal opacification and edema, a shallow anterior chamber, midriasis of the pupil, absence of light reflexes (direct and consensual), lens opacification, and chemosis (+). This case underscores the importance of early diagnosis of chronic angle closure glaucoma to prevent adverse prognostic outcomes.

Keywords: Chronic Angle Closure Glaucoma, Vision, Preventing Adverse Outcomes

Azuara-Blanco, A., Burr, J., Ramsay, C., Cooper, D., Foster, P. J., Friedman, D. S., Scotland, G., Javanbakht, M., Cochrane, C., & Norrie, J. (2016). Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. The Lancet, 388(10052), 1389–1397. https://doi.org/10.1016/S0140-6736(16)30956-4

Dias, D. T., Ushida, M., Battistella, R., Dorairaj, S., & Prata, T. S. (2017). Neurophthalmological conditions mimicking glaucomatous optic neuropathy: analysis of the most common causes of misdiagnosis. BMC Ophthalmology, 17(1), 2. https://doi.org/10.1186/s12886-016-0395-x

European Glaucoma Society. (2017). European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 2: Classification and terminologySupported by the EGS Foundation. British Journal of Ophthalmology, 101(5), 73–127. https://doi.org/10.1136/bjophthalmol-2016-EGSguideline.002

Fea, A. M., Dallorto, L., Lavia, C., Pignata, G., Rolle, T., & Aung, T. (2018). Long‐term outcomes after acute primary angle closure of Caucasian chronic angle closure glaucoma patients. Clinical & Experimental Ophthalmology, 46(3), 232–239. https://doi.org/10.1111/ceo.13024

Friedman, D. S., Chang, D. S.-T., Jiang, Y., Huang, S., Kong, X., Munoz, B., Aung, T., Foster, P. J., & He, M. (2019). Darkroom prone provocative testing in primary angle closure suspects and those with open angles. British Journal of Ophthalmology, bjophthalmol-2018-313362. https://doi.org/10.1136/bjophthalmol-2018-313362

Izquierdo Villavicencio, J. C., Agudelo Arbelaez, N., Lastra, B. R., Ramirez, I., Quezada, F., Ponte, M. C., Cañola, L., & Mejias Smith, J. (2019). Primary Outcomes of Patients with Chronic Angle-Closure Glaucoma Treated with Combined Phacoemulsification, Viscogoniosynechialysis, and Endocyclophotocoagulation. Journal of Ophthalmology, 2019, 1–5. https://doi.org/10.1155/2019/6378489

Jonas, J. B., Aung, T., Bourne, R. R., Bron, A. M., Ritch, R., & Panda-Jonas, S. (2017). Glaucoma. The Lancet, 390(10108), 2183–2193. https://doi.org/10.1016/S0140-6736(17)31469-1

Peterson, J. R., Anderson, J. W., Blieden, L. S., Chuang, A. Z., Feldman, R. M., & Bell, N. P. (2017). Long-term Outcome of Argon Laser Peripheral Iridoplasty in the Management of Plateau Iris Syndrome Eyes. Journal of Glaucoma, 26(9), 780–786. https://doi.org/10.1097/IJG.0000000000000731

Preda, M. A., Karancsi, O. L., Munteanu, M., & Stanca, H. T. (2020). Clinical outcomes of micropulse transscleral cyclophotocoagulation in refractory glaucoma—18 months follow-up. Lasers in Medical Science, 35(7), 1487–1491. https://doi.org/10.1007/s10103-019-02934-x

Quek, D. T. L., Koh, V. T., Tan, G. S., Perera, S. A., Wong, T. T., & Aung, T. (2011). Blindness and Long-Term Progression of Visual Field Defects in Chinese Patients With Primary Angle-Closure Glaucoma. American Journal of Ophthalmology, 152(3), 463–469. https://doi.org/10.1016/j.ajo.2011.02.023