title: Iridocorneal Endothelial Syndrome Presenting With Large Diurnal Intraocular Pressure Fluctuation.
abstract: OBJECTIVE
  The purpose of the study was to report a case of iridocorneal endothelial syndrome with an initial presentation of a large diurnal fluctuation of intraocular pressure (IOP) which peaked early in the morning.
  
  
  METHODS
  A 31-year-old white man had transient blurry vision oculus sinister (OS) upon awakening in the morning for the past 2 months. The blurry vision improved within 1 to 2 hours. Clinical examination, diurnal IOP measurements, and specular microscopy were performed to investigate the cause of his transient blurry vision.
  
  
  RESULTS
  At 6 AM, IOP OS was 38 mm Hg with corneal edema and visual acuity of 20/30. At 8 AM, IOP OS decreased to 25 mm Hg with clear cornea and visual acuity of 20/20. Diurnal IOP measurements revealed a large fluctuation OS (18 mm Hg). Specular microscopy revealed pleomorphism, polymegathism, light peripheral borders and light/dark reversal of the corneal endothelium OS. IOP oculus dexter remained within normal limits with clear cornea and stable visual acuity throughout the diurnal measurements.
  
  
  CONCLUSIONS
  In patients with consistent daily episodes of transient blurry vision, clinicians should suspect a large diurnal IOP fluctuation with high peak IOP. If symptoms and signs are unilateral, iridocorneal endothelial syndrome should be included in the differential diagnosis and corneal specular microscopy should be obtained.
authors.affiliation: *Department of Ophthalmology, Manhattan Eye, Ear & Throat Hospital †Department of Ophthalmology, Hofstra Northwell School of Medicine, Hempstead, NY.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Mogil
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Andrew
authors.initials: A
authors.lastname: Tirsi
authors.forename: Celso
authors.initials: C
authors.lastname: Tello
authors.forename: Sung Chul
authors.initials: SC
authors.lastname: Park
mesh_terms: D000328:Adult; D002940:Circadian Rhythm / Q000502:physiology*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D057129:Iridocorneal Endothelial Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D009798:Ocular Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests