Recommendations for intraocular pressure measurement one hour after laser peripheral iridotomy: Review of the literature

Purpose: To report a patient with fluctuating refraction following the use of oral topiramate. Case report: A 38-year-old male patient was diagnosed elsewhere with sudden-onset-acquired myopia, high intraocular pressure, and bilateral angle closure glaucoma for which he underwent laser peripheral iridotomy in both eyes and was started on topical antiglaucoma medications and topical steroids following laser peripheral iridotomy. He was referred for ultrasound biomicroscopy, which showed bilateral ciliary effusion. Ultrasound of eyes revealed choroidal thickening. On further questioning, he was noted to have taken oral topiramate for 7 days, which he stopped a week before the ocular symptoms. He was started on atropine, on which the acquired myopia resolved, the anterior chamber deepened, and the intraocular pressure came down. After 4 days, he developed acquired hyperopia in the left eye. Neurosensory retinal detachment at the posterior pole was documented with optical coherence tomography. The fluorescein angiography showed few ink-blot leaks and one smokestack leak in the left eye. The neurosensory detachment resolved spontaneously with an uncorrected visual acuity of 6/6 in either eye. Conclusion: A unique case of central serous chorioretinopathy following oral intake of topiramate is presented. This patient had also received laser peripheral iridotomy and topical steroids following the peripheral iridotomy.

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Comparing brimonidine 0.2% to apraclonidine 1.0% in the prevention of intraocular pressure elevation and their pupillary effects following laser peripheral iridotomy

Japanese Journal of Ophthalmology ◽

10.1007/s10384-004-0149-9 ◽

2005 ◽

Vol 49 (2) ◽

pp. 89-92 ◽

Cited By ~ 18

Author(s):

Nancy S.Y. Yuen ◽

Peggy Cheung ◽

Sui Ping Hui

Keyword(s):

Intraocular Pressure ◽

Laser Peripheral Iridotomy ◽

Pressure Elevation ◽

Intraocular Pressure Elevation ◽

Peripheral Iridotomy

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Comparison of Intraocular Pressure and Anterior Chamber Angle Changes between Pilocarpine and Laser Peripheral Iridotomy

Current Journal of Glaucoma Practice with DVD ◽

10.5005/jp-journals-10078-1245 ◽

2019 ◽

Vol 13 (1) ◽

pp. 32-36 ◽

Cited By ~ 1

Author(s):

Ardiella Yunard ◽

Virna D Oktariana ◽

Widya Artini ◽

Joedo Prihartono

Keyword(s):

Intraocular Pressure ◽

Anterior Chamber ◽

Anterior Chamber Angle ◽

Laser Peripheral Iridotomy ◽

Peripheral Iridotomy ◽

Chamber Angle

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Role of laser peripheral iridotomy in pigmentary glaucoma and pigment dispersion syndrome: A review of the literature

Journal Français d Ophtalmologie ◽

10.1016/j.jfo.2017.09.002 ◽

2017 ◽

Vol 40 (9) ◽

pp. e315-e321 ◽

Cited By ~ 1

Author(s):

J. Buffault ◽

B. Leray ◽

A. Bouillot ◽

C. Baudouin ◽

A. Labbé

Keyword(s):

Pigment Dispersion ◽

Pigmentary Glaucoma ◽

Review Of The Literature ◽

Laser Peripheral Iridotomy ◽

Pigment Dispersion Syndrome ◽

Peripheral Iridotomy

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Role of Sequential Treatment of Paracentesis Followed by Laser Peripheral Iridotomy in Acute Primary Angle Closure

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v13i1.9 ◽

1970 ◽

Vol 13 (1) ◽

pp. 3-8

Author(s):

Widya Artini ◽

Tjahjono D. Gondowiardjo ◽

Edi S. Afandi

Keyword(s):

Intraocular Pressure ◽

Sequential Treatment ◽

Angle Closure ◽

Laser Peripheral Iridotomy ◽

Duration Of Symptoms ◽

Acute Primary Angle Closure ◽

Primary Angle Closure ◽

The Mean ◽

Peripheral Iridotomy

Aim: To assess the role of sequential treatment of paracentesis followed by laser peripheral iridotomy in acute primary angle closure.Methods: This was a prospective interventional study of acute primary angle closure in Indonesian patients. All eyes underwent paracentesis immediately after admission to reduce the intraocular pressure, followed by laser peripheral iridotomy on the following day to relieve pupillary blockade. A comprehensive eye examination was performed. The criterion for success was intraocular pressure <21 mm Hg with or without glaucoma medication. Risk factors assessed were age, duration of acute symptoms, presenting intraocular pressure, intraocular pressure response to paracentesis and to laser peripheral iridotomy, anterior chamber depth, and extent of peripheral anterior synechiae.Results: Forty five eyes of 45 patients with acute primary angle closure were recruited, of whom 38 were women. The duration of symptoms ranged from 2 to 30 days (median, 14 days). The mean extent of peripheral anterior synechiae was 7.7 clock hours (SD, 3.1 clock hours) and the mean presenting intraocular pressure was 55.9 mm Hg (SD, 13.4 mm Hg; range, 30.0-78.0 mm Hg). After paracentesis, the mean intraocular pressure decreased to 27.0 (SD, 12.8 mm Hg; range, 15.0-54.0 mm Hg). After laser peripheral iridotomy, the mean intraocular pressure was 24.0 mm Hg (SD, 15.2 mm Hg; range 8.0-40.0 mm Hg). Success was achieved in 21 eyes and the variable risk factor influencing success was extent of peripheral anterior synechiae.Conclusion: The success rate for sequential treatment was 47% of affected eyes and was determined mostly by the extent of peripheral anterior synechiae.

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Bilateral simultaneous acute angle closure in an adult Nepalese woman

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i1.348 ◽

2018 ◽

Vol 16 (1) ◽

pp. 51-54

Author(s):

Sabin Sahu ◽

Lila Raj Puri

Keyword(s):

Intraocular Pressure ◽

Corneal Edema ◽

Acute Angle ◽

Posterior Segment ◽

Angle Closure ◽

Laser Peripheral Iridotomy ◽

Peripheral Iridectomy ◽

Acute Angle Closure ◽

The Right ◽

Peripheral Iridotomy

Purpose: To report a case of bilateral simultaneous angle closure in an adult Nepalese woman without any known secondary cause. Methods: Observational case report. Results: A 50-year-old Nepalese woman presented with decreased vision, pain, redness, and watering in both eyes with associated coloured haloes, nausea, and vomiting for 10 days. At presentation, her visual acuity was 20/400 in the right eye and hand motions close to face with accurate projection of rays in the left eye. Intraocular pressure was 38 mmHg in the right eye and 48 mmHg in the left eye without any antiglaucoma medications. A slit-lamp examination revealed bilateral circum-corneal conjunctival congestion, corneal edema, and shallow anterior chambers. Both pupils were mid-dilated and non-reactive to light. Gonioscopy showed closed angles in all four quadrants bilaterally. Posterior segment examination revealed normal optic disc with cup-disc-ratio of 0.3 in the right eye, and blurring of disc margin with cup-disc-ratio of 0.3 in the left eye. The patient was started on systemic acetazolamide 250 mg 4 times a day, topical brimonidine 0.2% and timolol 0.5% 2 times a day, and topical dexamethasone 6 times a day in both eyes, following which IOP reduced to 11 and 12 mmHg, respectively, the corneal edema subsided, but the anterior chamber remained shallow. Laser peripheral iridotomy was performed in the right eye and surgical peripheral iridectomy was performed in the left eye. After two weeks, vision improved to 20/30 in both eyes with normal intraocular pressure off antiglaucoma medications. Anterior chambers deepened significantly with clear corneas bilaterally. Gonioscopy at this stage showed essentially open angles with appositional closure in superior and temporal quadrants in the right eye and open angles in all four quadrants in the left eye. Posterior segment evaluation revealed normal optic disc in both eyes. Conclusions: Bilateral simultaneous acute angle closure is a rare presentation with very few reported secondary causes. We report a case of bilateral simultaneous angle closure in an adult Nepalese woman without any known secondary cause. The case was successfully managed with laser peripheral iridotomy in the right eye and surgical peripheral iridectomy in the left eye.

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