Ocular Complications 1 Month After Being Punched

Rachel N. Brackley, OD; Case Series Editor: Jean Marie Pagani, OD

Disclosures

December 17, 2013

Case Diagnosis

As a result of the gonioscopic view of the angle and the presence of asymmetric intraocular pressure (IOP), a diagnosis of angle recession glaucoma OD was made. Gonioscopy demonstrated a wider-than-normal ciliary body in some quadrants caused by disruptions in the fibers of the ciliary body, a normal ciliary body band in other quadrants, and torn iris processes.

In primary open-angle glaucoma, IOP would be increased in both eyes, without visible damage to structures of the angle.

Although an asymmetric IOP was found, no pseudoexfoliative material was seen on the anterior capsule of the lens, eliminating the diagnosis of pseudoexfoliation glaucoma.

In narrow-angle glaucoma, the gonioscopy would show very few angle structures. In this case, the ciliary body is present, excluding the diagnosis. A patient with anatomically narrow angles may have had a past angle closure attack with previous symptoms, including headache, eye pain, and intermittent blurred vision.

Uveitic glaucoma would cause a unilateral increase in IOP, but with the lack of inflammation in the anterior chamber and peripheral anterior synechiae in the angle, the diagnosis can be excluded.

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