Secondary glaucoma as a result of a sling shot accident, diagnosed half a century later

Secondary glaucoma following blunt trauma is relatively uncommon in regular optometric practice. Onset of this type of glaucoma may occur within weeks, but may also be delayed several decades. This case report presents a 57 year old male who, 48 years ago, suffered a sling shot accident yet was only recently diagnosed with traumatic glaucoma in his left eye. The trauma caused severely reduced vision in his left eye but, aside from this, the patient did not report any eye- or vision problems and he had never had an eye examination as an adult. He successfully wore ready-made glasses for near work. While all findings were normal in his right eye, his left eye showed reduced vision, inferionasal iridodialysis, angle recession, increased intraocular pressure and heavily excavated optic nerve head. The patient was referred to an ophthalmologist who confirmed unilateral glaucoma. The case report reviews situations where secondary glaucoma from blunt trauma may occur, which ocular signs might be present and which ocular examinations should be undertaken. Further, the importance of following up patients with ocular trauma is discussed.

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Optic Nerve Avulsion and Retinal Detachment After Penetrating Ocular Trauma: Case Report

Turkish Journal of Ophthalmology ◽

10.4274/tjo.31549 ◽

2018 ◽

pp. 89-91 ◽

Cited By ~ 1

Author(s):

Mehmet Fatih Kağan Değirmenci ◽

Nilüfer Yalçındağ ◽

Hüban Atilla

Keyword(s):

Case Report ◽

Optic Nerve ◽

Retinal Detachment ◽

Ocular Trauma ◽

Trauma Case ◽

Penetrating Ocular Trauma

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Contusion of the optic nerve after minor blunt ocular trauma: case report and review of the literature

Der Ophthalmologe ◽

10.1007/s003470050449 ◽

1999 ◽

Vol 96 (8) ◽

pp. 529-533 ◽

Cited By ~ 5

Author(s):

Hans-Jürgen Buchwald ◽

Wolf Eckhard Weingärtner ◽

Christoph Wolfgang Spraul ◽

Peter Wagner ◽

Gerhard Klaus Lang

Keyword(s):

Case Report ◽

Optic Nerve ◽

Ocular Trauma ◽

Review Of The Literature ◽

Trauma Case ◽

Blunt Ocular Trauma

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Optic nerve avulsion after blunt ocular trauma – Case report

Annals of Agricultural and Environmental Medicine ◽

10.5604/12321966.1203911 ◽

2016 ◽

Vol 23 (2) ◽

pp. 382-383 ◽

Cited By ~ 3

Author(s):

Jerzy Mackiewicz ◽

Joanna Tomaszewska ◽

Monika Jasielska

Keyword(s):

Case Report ◽

Optic Nerve ◽

Ocular Trauma ◽

Trauma Case ◽

Blunt Ocular Trauma

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Secondary glaucoma due to thrombosis of sigmoid and transverse sinus

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v17i2.532 ◽

2020 ◽

Vol 17 (2) ◽

pp. 142-146

Author(s):

Vijaya Pai H. ◽

Matta Rudhira Reddy

Keyword(s):

Intraocular Pressure ◽

Case Report ◽

Open Angle Glaucoma ◽

Venous Pressure ◽

Transverse Sinus ◽

Secondary Glaucoma ◽

Sigmoid Sinus ◽

Open Angle ◽

Relative Afferent Pupillary Defect ◽

First Case

An 88-year-old female presented with redness in the left eye of one-month duration. On examination, the left eye showed 3 mm of proptosis with dilated and tortuous episcleral vessels and relative afferent pupillary defect. Intraocular pressure was 60 mmHg and showed open angles on gonioscopy with cup disc ratio of 0.8 in OS. A diagnosis of secondary open-angle glaucoma due to elevated episcleral venous pressure (EVP) was made. Magnetic resonance venogram revealed thrombosis of transverse and sigmoid sinus on the left side. This is the first case report of secondary open-angle glaucoma due to elevated EVP following thrombosis of transverse and sigmoid sinus.

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Trabeculectomy in Staphyloma Eye with High Intraocular Pressure Following Ocular Trauma – A Case Report

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6313 ◽

2021 ◽

Vol 9 (T3) ◽

pp. 23-25

Author(s):

Masitha Dewi Sari

Keyword(s):

Intraocular Pressure ◽

Case Report ◽

Anterior Chamber ◽

Ocular Trauma ◽

Anterior Segment ◽

Rectus Muscle ◽

Tissue Destruction ◽

Corneal Scar ◽

History Of ◽

Blurry Vision

BACKGROUND: Ocular trauma may alter the anterior segment condition that may lead to secondary glaucomas such as inflammation, hyphema, angle recession, and lens subluxation. One of the most common procedures to decrease intraocular pressure (IOP) is trabeculectomy by creating pathways that allow aqueous humor to flow out of the anterior chamber. Scleral tissue destruction can cause damage in thin areas (such as posterior to the rectus muscle insertions) as in case of scleritis. CASE REPORT: An 11-year-old boy presented to the Ophthalmology Department of Universitas Sumatera Utara Hospital with a bigger white grayish mass and blurry vision. There was a history of the left ocular trauma 6 years ago, followed by redness of the eye, but not treated properly. On the general examination, the patient’s left eyes looked cloudy. On ocular examination, the left eye visual acuity was 1/300 and IOP was 28 mmHg. Segment anterior examination showed staphyloma from 9 to 12 o’clock, conjunctival injection, corneal scar, shallow anterior chamber, and cloudy lens. We could not asses the posterior segment due to cloudy media. We gave anti-glaucoma medication for 1 month, but the IOP did not decrease. We performed a trabeculectomy to control IOP and to prevent staphyloma from getting bigger. CONCLUSION: Trabeculectomy was an effective procedure to control IOP in a staphyloma eye following ocular trauma.

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Reversal of isolated unilateral optic nerve edema with concomitant visual impairment following blunt trauma: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-2-50 ◽

2008 ◽

Vol 2 (1) ◽

Cited By ~ 7

Author(s):

Marc Maegele

Keyword(s):

Case Report ◽

Optic Nerve ◽

Visual Impairment ◽

Blunt Trauma

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Traumatic avulsion of the globe and optic nerve in a road traffic accident

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20174857 ◽

2017 ◽

Vol 4 (11) ◽

pp. 4348

Author(s):

Ritesh Verma ◽

Manisha Rathi ◽

Sumit Sachdeva ◽

C. S. Dhull ◽

Jitender Phogat

Keyword(s):

Case Report ◽

Optic Nerve ◽

Road Traffic Accident ◽

Traffic Accident ◽

Third World ◽

Ocular Trauma ◽

Road Traffic ◽

Two Wheeler ◽

Traffic Rules

Road traffic accident is one of the important causes of ocular trauma. There is a need for strict traffic rules in third world countries where a majority of people travel on two wheelers and that too without a helmet. People generally tend to over speed or try to fit in their children on a two wheeler in our country. In this case report, we present a case of complete avulsion of eye ball and optic nerve in a patient of a road traffic accident. There are no documented cases of avulsion of the globe and optic nerve due to a road traffic accident in the available literature.

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Asymptomatic chronic hypotony due to subclinical choroidal effusion after blunt trauma

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v17i2.571 ◽

2020 ◽

Vol 17 (2) ◽

pp. 203-208

Author(s):

John Mark Sim De Leon ◽

Ronald Steven Medalle

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Case Report ◽

Blunt Trauma ◽

Ultrasound Biomicroscopy ◽

Scleral Flap ◽

Hypotony Maculopathy ◽

Post Traumatic ◽

Choroidal Effusion ◽

Cyclodialysis Cleft

Objective: To present a case report of asymptomatic post-traumatic chronic hypotony in which the cause was undetected until phacoemulsification. Methodology: Case report. Results: A 55-year-old female’s left eye suffered blunt trauma causing hyphema and iritis, which were successfully managed; however, up to a year after, the intraocular pressure (IOP) ranged from 3 to 5 mmHg and the anterior chamber remained very shallow (Van Herick grade 4) with the lens–iris diaphragm pushed anteriorly with difficulty assessing the angles for recession or clefts . Visual acuity was initially 20/20 upon resolution of the hyphema but worsened to 20/40 a year after, presumably due to a developing cataract. Periodic dilated fundus examinations revealed no hypotony maculopathy or choroidal effusions. Prior to phacoemulsification, ultrasound biomicroscopy (UBM) revealed 360 degrees of mild peripheral choroidal effusions. During phacoemulsification, after intraocular lens insertion, direct gonioscopy revealed a supero-nasal cyclodialysis cleft (2 clock hours) and this was repaired intraoperatively with direct cyclopexy through a partial thickness scleral flap. Postoperatively, the vision improved to 20/20 without correction and the IOP normalized to 16 to 18 mmHg. Conclusion: Chronic hypotony post-trauma may be asymptomatic and the cause may not be clinically evident and may be detected by UBM (choroidal effusion). In our case, the proximate aetiology (cyclodialysis cleft) of the effusion was only observed intraoperatively after phacoemulsification for which cyclopexy was performed which increased the IOP to physiologic levels.

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Goniosynechialysis combined with multiple surgeries for secondary glaucoma in nanophthalmos: A case report

European Journal of Ophthalmology ◽

10.1177/1120672120971187 ◽

2020 ◽

pp. 112067212097118

Author(s):

Ruoshi Li ◽

Mei Li ◽

Shijie Zhang

Keyword(s):

Intraocular Pressure ◽

Case Report ◽

Axial Length ◽

Secondary Glaucoma ◽

Angle Closure ◽

Case Presentation ◽

Anterior Vitrectomy ◽

Peripheral Iridectomy ◽

Shallow Anterior Chamber

Background: Management of secondary glaucoma in nanophthalmos has always been challenging, especially for patients with extremely short axial length and extensive angle synechia. This case report discusses a nanophthalmic patient with secondary glaucoma and extensive angle synechia. Case presentation: A 60-year-old woman was referred to our hospital with uncontrolled intraocular pressure (IOP) in her left eye (LE). Slitlamp examination revealed small cornea and shallow anterior chamber (AC) in both eyes. Extensive angle synechia was seen on gonioscopy, and the IOP and axial length were 36 mmHg/15.79 mm in the left eye. She was diagnosed with nanophthalmos and secondary angle-closure glaucoma LE. Laser peripheral iridectomy (LPI) was performed, but the IOP LE remained elevated and uncontrolled on brinzolamide and brimonidine. The IOP LE was then normalized with the application of 2% pilocarpine. During the follow-up period, the AC of the LE showed progressive shallowing, and 5 months post LPI the IOP became uncontrollable. Goniosynechialysis combined with phacoemulsification, lamellar sclerectomy, sclerostomy, peripheral iridectomy, capsulotomy, and anterior vitrectomy were performed LE. Immediately after surgery, the AC deepened and the IOP stabilized. However, the IOP rose again post-surgically at 1 week and again at 2 months. A generally shallow AC and obstructed capsule hole were present. YAG laser capsulotomy was performed, and the IOP normalized and the AC deepened. Eighteen months after surgery, the IOP LE was 12 mmHg and the AC remained stable. Conclusion: Goniosynechialysis combined with multiple surgical procedures could be considered an alternative treatment regimen for nanophthalmos patients with secondary glaucoma and extensive angle synechia.

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