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Acute angle-closure glaucoma from spontaneous massive hemorrhagic retinal detachment
Yoon Jung Lee1, Sung Min Kang, Il Bong Kang
1Department of Ophthalmology, Hanyang University, School of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea. lyjot@hanyang.ac.kr
Korean Journal of Ophthalmology : KJO
|April 27, 2007
Summary
Spontaneous hemorrhagic retinal detachment can cause acute angle-closure glaucoma. Enucleation may be necessary if medical treatments fail or an intraocular tumor is suspected.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Retinal Diseases
Background:
- Acute angle-closure glaucoma is a serious condition characterized by sudden, severe elevation in intraocular pressure.
- Retinal detachment occurs when the retina separates from the underlying tissue, potentially leading to vision loss.
Observation:
- An 81-year-old woman presented with severe ocular pain and vision loss in her left eye.
- Diagnostic imaging revealed retinal detachment caused by subretinal hemorrhage.
- The patient's intraocular pressure was significantly elevated (58 mmHg) in the affected eye, with a shallow anterior chamber and closed angle.
Findings:
- Ocular pathology confirmed that a large subretinal hemorrhage led to retinal detachment.
- This hemorrhage displaced the lens-iris diaphragm, causing secondary angle-closure glaucoma.
- Medical management for glaucoma was unsuccessful in alleviating the patient's pain.
Implications:
- Prolonged anticoagulant therapy is a potential risk factor for hemorrhagic retinal detachment and secondary angle-closure glaucoma.
- Enucleation should be considered for intractable pain or suspected intraocular tumors when medical therapy is ineffective.
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