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Simultaneous angle closure in twins
Journal of Glaucoma
|March 11, 1998
Summary
Identical twins simultaneously developed acute angle-closure glaucoma, suggesting genetic and environmental factors contribute to this eye condition. Early screening for potentially occludable angles is recommended, especially for twins.
Area of Science:
- Ophthalmology
- Genetics
- Public Health
Background:
- Primary angle-closure glaucoma (PACG) is a significant cause of irreversible blindness worldwide.
- Genetic predisposition and environmental triggers are implicated in PACG development.
- Identical twins share nearly 100% of their genes, making them valuable for studying genetic influences on diseases.
Observation:
- Two 73-year-old identical twin sisters presented concurrently with acute angle-closure glaucoma.
- Both sisters experienced sudden vision loss and eye pain.
- Clinical examination revealed significantly elevated intraocular pressure and signs of angle closure in one or both eyes for each twin.
Findings:
- The simultaneous occurrence of acute angle-closure glaucoma in identical twins suggests a strong genetic component.
- Environmental factors, such as physical trauma (a reported fist fight), may act as triggers in genetically susceptible individuals.
- Both patients responded to medical management with anti-glaucoma medications and surgical intervention with bilateral laser iridotomies.
Implications:
- This case highlights the importance of considering genetic factors in the etiology of angle-closure glaucoma.
- Screening for potentially occludable angles is crucial in first-degree relatives of PACG patients, particularly in twin pairs.
- Understanding the interplay between genetics and environment can lead to improved preventative strategies and earlier detection of glaucoma.
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