title: Aqueous misdirection syndrome: an interesting case presentation.
abstract: OBJECTIVE
  To report a case of an aqueous misdirection-like presentation in a pseudophakic patient.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  An 84-year-old pseudophakic gentleman presented with bilateral blurred vision 8 years after cataract surgery. A refractive shift with shallow anterior chambers and elevated intraocular pressures were noted. No corneal edema was noted. Although aqueous suppression and topical atropine would relieve the signs and symptoms, the effect was temporary with fluctuating and variable changes in refraction, anterior chamber depth, and intraocular pressure. The presence of patent iridotomies had no effect on the fluctuations. A pars plana vitrectomy and surgical iridectomy were successful in preventing further fluctuations.
  
  
  CONCLUSIONS
  Aqueous misdirection is a form of secondary angle closure glaucoma marked by elevated intraocular pressures, myopic shift in refraction, and central shallowing of the anterior chamber. Here, a case of a pseudophakic patient experiencing bilateral and fluctuating signs and symptoms resembling aqueous misdirection is presented. Surgical intervention with a pars plana vitrectomy and iridectomy prevented further fluctuations.
authors: Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
authors: Prima
authors: P
authors: Moinul
authors: Ivey Eye Institute, St Joseph's Health Care, Department of Ophthalmology, University of Western Ontario, London, ON, Canada.
authors: Cindy Ml
authors: CM
authors: Hutnik
keywords: aqueous misdirection; glaucoma; pars plana vitrectomy; secondary angle closure