DR.AMIT PATHAK

DR. A. VIJAYALAKSHMI, DR. SUJITHA RAMESH

Abstract

We report 2 cases of SACG in patients with TED.In Case 1,a 49 year old hyperthyroid male presented with BCVA 6/18 and IOP 70mmHg in OD.He had axial proptosis,shallow AC,mid-dilated pupil,occludable angles on gonioscopy.Laser peripheral iridotomy(LPI) was done and IOP reduced to 24mmHg with deepening of AC.Unilateral acute pupillary block glaucoma secondary to TED was diagnosed.In Case 2,a 47 year old hyperthyroid man presented with BCVA 6/6 and IOP 38mm Hg in OD.Clinical evaluation showed axial proptosis,shallow AC and UBM showed anteriorly rotated ciliary body.LPI was done in OD but IOP was 34mmHg with patent PI.Cycloplegics and anti-glaucoma medication were given and after 2 weeks,IOP was 18mm Hg,AC deepened,UBM showed normal ciliary body position.Aqueous misdirection was diagnosed based on shallow AC despite patent PI,UBM findings and response to cycloplegics.SACG due to TED is rare and should be diagnosed by meticulous clinical evaluation and anterior segment imaging modalities.