A CASE REPORT OF FUCHS’ HETEROCHROMIC IRIDOCYCLITIS WITH SECONDARY GLAUCOMA

Title A CASE REPORT OF FUCHS’ HETEROCHROMIC IRIDOCYCLITIS WITH SECONDARY GLAUCOMA
Author, Co-Author Victoria Bulbin
Topic
Year
2003
Day
Program Number
Poster 92
Room
Affiliation
State University of New York, College of Optometry
Abstract PURPOSE: Fuchs’ heterochromic iridocyclitis is a rare and atypical form of anterior uveitis. It usually presents with a mild anterior chamber reaction, small diffused keratic precipitates, absence of posterior synechia and iris hypochromia. Iris and angle neovascularization can also be noted. The condition is usually unilateral and is often associated with cataracts and glaucoma

METHODS: 61 WM presented with a complaint of blurry vision in his left eye. The patient had a history of cataract extraction with posterior chamber IOL in both eyes. He was also recently diagnosed with glaucoma in his left eye and was prescribed Cosopt bid OS which he wasn’t using at the time of initial examination.

The patient’s medical history was unremarkable. Best corrected visual acuity was 20/30+ OD ad 20/40-2 OS. Trace RAPD OS was noted. Slit lamp evaluations revealed multiple stellate white keratic precipitates, trace anterior chamber reaction, iris hypochromia and neovascularization were noted OS. Intraocular pressures were 16 mm Hg OD and 40 mm Hg OS. Fundi examination revealed C/D ratio 0.4 OD and 0.6 OS. Mild epiretinal membrane was noted OS. Visual field testing showed no defect OD and superior arcuate defect OS.


RESULTS: A diagnosis of Fuchs’ heterochromic iridocyclitis with secondary glaucoma was made. The patient was treated with Cosopt bid OS and Vexol qid OS. Then Alphagan bid OD was added and it stabilized the intraocular pressure

During the two year period the patient had multiple spikes of intraocular pressure ranging from 28 to 38 mm Hg. The patient underwent glaucoma valve implantation and pars plana vitrectomy

CONCLUSIONS: Fuchs heterochromic iridocyclitis is an important diagnosis to make because the treatment can be different than other forms of anterior uveitis. A number of studies have shown poor response to steroid therapy and difficulty lowering intraocular pressure with ocular medications. It can potentially lead to severe secondary glaucoma and may need surgical intervention
Affiliation of Co-Authors
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