open access

  • Abstract viewed - 53 times
  • PDF downloaded - 28 times
Submitted: 2023-09-11
DOI: 10.35119/myjo.v7i2.399
Case Reports
Published: 2025-11-28

Is this really juvenile glaucoma?

Department of Ophthalmology, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Perak, Malaysia
Department of Ophthalmology, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Perak, Malaysia
Department of Ophthalmology, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Perak, Malaysia
##plugins.themes.healthSciences.article.authorBio##
anterior segment optical coherence tomography laser peripheral iridotomy pigmentary glaucoma

Abstract

Background: Pigmentary glaucoma (PG) is a clinical diagnosis characterised by liberation of pigments from the iris pigment epithelium into the anterior segment, with the evidence of glaucomatous optic neuropathy.

Case presentation: A 34-year-old man presented with bilateral visual acuity of 6/9, normal anterior segment, intraocular pressure of 17 mmHg on 3 antiglaucoma eyedrops and cup-to-disc ratio of 0.8. Gonioscopy showed open angles in both eyes. Initial diagnosis was bilateral juvenile open-angle glaucoma. During subsequent follow-up, he was noticed to have bilateral concave iris and dense hyperpigmentation in both angles. Anterior segment optical coherence tomography (AS-OCT) showed bilateral posterior bowing of the mid-iris. Therefore, diagnosis was revised to PG. The reverse pupillary block was successfully treated with laser peripheral iridotomy.

Conclusion: The use of AS-OCT provides an objective visualisation of iris configuration, which aids in the diagnosis of PG.