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Aqueous misdirection syndrome: an interesting case presentation.

Prima Moinul1, Cindy Ml Hutnik2

  • 1Faculty of Medicine, University of Calgary, Calgary, AB, Canada.

Clinical Ophthalmology (Auckland, N.Z.)
|February 14, 2015
PubMed
Summary

This case report details a pseudophakic patient with fluctuating vision, shallow anterior chambers, and high intraocular pressure, mimicking aqueous misdirection. Pars plana vitrectomy and iridectomy successfully resolved these symptoms, preventing recurrence.

Keywords:
aqueous misdirectionglaucomapars plana vitrectomysecondary angle closure

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Area of Science:

  • Ophthalmology
  • Glaucoma Research

Background:

  • Aqueous misdirection is a rare condition causing secondary angle closure glaucoma.
  • It is characterized by elevated intraocular pressure, myopic shift, and shallow anterior chambers.

Observation:

  • An 84-year-old pseudophakic male presented with bilateral blurred vision 8 years post-cataract surgery.
  • Symptoms included fluctuating refractive shifts, shallow anterior chambers, and elevated intraocular pressure, unresponsive to medical management.
  • Patent iridotomies did not alleviate the fluctuating signs.

Findings:

  • The patient's presentation mimicked aqueous misdirection, despite being pseudophakic.
  • Pars plana vitrectomy and surgical iridectomy were effective in preventing further fluctuations.

Implications:

  • This case highlights a rare presentation of aqueous misdirection-like symptoms in a pseudophakic eye.
  • Surgical intervention may be a viable option for managing such complex cases.