DR. ANN MARY MATHEWS

DR. A. VIJAYALAKSHMI, DR. KRISHNA DAS R.

Abstract

A 57 year old female with no known comorbidities presented to us with bilateral acute angle closure attack with a 20 day history of sudden onset painful blurring of vision in both eyes and headache. Corneal edema and pain persisted despite intravenous mannitol,oral and topical antiglaucoma medicines. Posterior segment examination was normal. We came to a diagnosis of nanophthalmos supported by low axial length and increased retinal-choroidal-scleral thickness by B-mode USG. Other possible causes like drug induced and Vogt Koyanagi Harada syndrome was excluded.Since laser peripheral iridotomy was not feasible due to severe corneal edema, we went ahead with sequential phacoemulsification and the angle closure was relieved.The post operative phase was uneventful.Hence echography should be routinely done to assess axial length and RCS thickness in such scenarios.Early lens extraction effectively relieves angle closure in these high risk eyes.