Dr.Md Imdadur Rahman, Dr.Tanveer Ahmed

Abstract

a 56 year old male presented with diminished vision in both eyes with pain and redness in left eye. with a provisional diagnosis of PACG in the left eye and open angle in right eye. On evaluation( perimetry, OCT RNFL) showed result within normal limits in both eyes. His BCVA came to 6/12 in both eyes. Hence anti glaucoma medications were started in left eye and laser peripheral iridotomy was done in left eye. Patient presented with similar complaints of acute attack of PACG with patent iridotomy in left eye. Left eye trabeculectomy was done. On AS-OCT lens iris diaphragm was placed anteriorly. Thus the event was considered to be precipitated because of lens induced glaucoma(phacomorphic type). This proves that patent laser iridotomy is not always the end solution of angle closure glaucoma and such cases should be carefully followed and monitored post LPI.