DR. MANOGNA AITHARAJU

DR. SONIA SINGH, DR.KARTHIK R MEDA, DR.M S RAVINDRA

Abstract

AIM – To report an interesting case of refractory glaucoma secondary to vasculitis of probable viral etiology

CASE SUMMARY – A 26 yr old presented with RE pain,blurred vision since 1month.On examination,LE was normal,BCVA in right eye was 6/12 with RAPD & IOP of 38mmHg. Gonioscopy showed grade 4 open angles with 1+ pigmentation. Dilated fundus in RE had 0.7CDR with sclerosed arterioles in all quadrants from midperiphery,LE was normal. FFA RE showed complete loss of peripheral perfusion. She was started on maximal medical therapy for glaucoma in RE. But IOP remained high. She was extensively investigated for the cause of vasculitis and was positive for only IGM herpes & IGG CMV. Trial of antiviral & topical steroids given but with no response.The patient was eventually taken up for trabeculectomy .

CONCLUSION – It’s a unique case of secondary glaucoma with neither visible inflammation nor any visible changes in trabecular meshwork and completely refractory to medical management