Bilateral acute angle closure glaucoma as a presentation of isolated microspherophakia in an adult: case report.
BACKGROUND
Bilateral simultaneous angle closure glaucoma is a rare entity. To our knowledge this is the first reported case of bilateral acute angle-closure glaucoma secondary to isolated microspherophakia in an adult.


METHODS
A 45-year-old woman presented with bilateral acute angle closure glaucoma, with a patent iridotomy in one eye. Prolonged miotic use prior to presentation had worsened the pupillary block. The diagnosis was not initially suspected, and the patient was subjected to pars-plana lensectomy and anterior vitrectomy for a presumed ciliary block glaucoma. The small spherical lens was detected intraoperatively, and spherophakia was diagnosed in retrospect. She had no systemic features of any of the known conditions associated with spherophakia. Pars-plana lensectomy both eyes controlled the intraocular pressure successfully.


CONCLUSIONS
This case demonstrates the importance of considering the diagnosis of isolated microspherophakia in any case of bilateral acute angle closure glaucoma. Lensectomy appears to be an effective first-line strategy for managing these patients.
Kaushik
Sushmita
S
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sushmita_kaushik@yahoo.com
Sachdev
Nishant
N
Pandav
Surinder Singh
SS
Gupta
Amod
A
Ram
Jagat
J
D003937:Diagnosis, Differential; D003949:Diagnostic Techniques, Surgical; D005124:Eye Abnormalities / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D007908:Lens, Crystalline / Q000002:abnormalities* / Q000601:surgery; D008875:Middle Aged; D016896:Treatment Outcome; D015348:Vision, Binocular