DR. SONY SINHA

DR. NISHA RUNGTA, DR. ALOK RANJAN, DR. PRATEEK NISHANT

Abstract

A 17-year-old girl presented with left-sided discolouration of periocular skin since birth, occasional headache and rapidly progressive diminution of vision in left eye. Corrected visual acuity was 6/6 in right eye and 6/600 in left eye. There was mild left-sided periocular hyperpigmentation (Tanino’s type 1A), left eye temporal and inferior scleral pigmentation, Krukenberg spindle, iris heterochromia, grade 3 relative afferent pupillary defect, and raised intraocular pressure (IOP) of 38 mmHg. Gonioscopy showed open angles with increased pigmentation. Fundus evaluation showed marked optic disc cupping (0.9:1) with intense pigmentation. Intravenous mannitol and topical antiglaucoma medication achieved IOP control. Patients with Nevus of Ota may require early glaucoma filtering surgery and lifelong follow-up with ophthalmologists and dermatologists. Our case highlights the importance of screening for open angle glaucoma in children with seemingly innocuous skin pigmentation.