The heredity and treatment of angle-closure glaucoma secondary to iris and ciliary body cysts

Three families with peripheral iris and ciliary body cysts are described. The cysts were multiple in 10 of the 11 affected patients, and they were bilateral in 8 of the 11. Angle closure glaucoma secondary to the cysts was present in 4 of the 11 cases. The management of this glaucoma requires a high index of suspicion, careful gonioscopic evaluation and proper medical and/or surgical treatment. Laser therapy for the angle closure caused by pigmented cysts may be curative. Nonpigmented ciliary body cysts are refractory to argon laser treatment and carry a poor prognosis. The cases described suggest an autosomal dominant hereditary pattern. The importance of examination and follow up of healthy relatives of patients with iris and ciliary body cysts is stressed, as early detection and treatment by laser cystotomy may prevent or cure angle closure glaucoma if the disease is diagnosed prior to the establishment of synechial closure.