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Primary Angle Closure in a 7-Year-Old Child: Evaluation and Findings With Conventional Ultrasound and Ultrasound
Abdulla K Ahmed1, Richard Stutzman2, William P Madigan3
1Ophthalmology, George Washington University School of Medicine and Health Sciences, Washington, USA.
Insights
This report details the youngest case of primary angle closure (PAC) in a child. Prompt diagnosis and laser iridotomy successfully treated this rare pediatric eye condition.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Primary angle closure (PAC) is uncommon in children.
- Typical risk factors include persistent hyperplastic vitreous, congenital cataracts, and ocular albinism.
Observation:
- A seven-year-old female presented with unilateral subacute PAC without known risk factors.
- Diagnostic imaging revealed a shallow anterior chamber and short axial length.
- Pupillary block due to anterior lens displacement caused the angle closure.
Findings:
- The patient, the youngest documented, was successfully treated with laser iridotomy.
- Ultrasound biomicroscopy confirmed the resolution of angle closure post-procedure.
Implications:
- This case underscores the need for early recognition and treatment of pediatric PAC.
- It highlights that PAC can occur in children without typical underlying conditions.
Abstract:
Primary angle closure (PAC) is rare in pediatric patients, typically associated with persistent hyperplastic vitreous, congenital cataracts, ocular surgery, retinopathy of prematurity, topical or oral medications, and ocular albinism. This case report describes the youngest documented case of unilateral subacute PAC in a seven-year-old female without these underlying conditions. The patient underwent evaluation using A-scan ultrasound and ultrasound biomicroscopy (UBM), revealing a shallow anterior chamber and a short axial length (20.45 ± 0.02 mm in the left eye). The angle closure was caused by a pupillary block associated with anterior displacement of the crystalline lens, unrelated to increased lens thickness or ciliary body abnormalities. A diagnosis was confirmed and laser iridotomy was performed, successfully resolving the condition. Postoperative UBM measurements confirmed the resolution of angle closure. This case highlights the importance of recognizing and promptly treating angle closure in pediatric patients, even in the absence of typical risk factors.
