A 61-year-old Black man with hypertension and diabetes presented with decreased vision 3 months after uneventful cataract surgery in his left eye. He had undergone laser retinopexy for retinal tears in his right eye and a scleral buckle and vitrectomy for a retinal detachment in his left eye 1 year earlier. Best-corrected visual acuity (BCVA) was 20/40 OD and counting fingers OS. Intraocular pressure (IOP) was 14 mm Hg in the right eye and 44 mm Hg in the left eye. Anterior segment examination of the right eye was unremarkable, while ophthalmoscopic examination showed vascular attenuation and treated retinal breaks. In the left eye, microcystic corneal edema and Descemet membrane folds limited examination, but no residual lenticular fragments or neovascularization of the iris or angle were seen. The patient was discharged taking timolol, dorzolamide, brimonidine, and prednisolone. Twelve days later, the cornea had cleared and IOP in the left eye improved to 32 mm Hg. Gonioscopy revealed 360° of anterior synechiae and complete angle closure, which was documented on ultrasound biomicroscopy (Figure 1). The patient started treatment with 500 mg of acetazolamide daily and referred to the glaucoma service for surgical evaluation.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Basil K. Williams Jr, MD, Department of Ophthalmology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Ste 5414, Cincinnati, OH 45267-0527 (email@example.com).
Published Online: March 16, 2023. doi:10.1001/jamaophthalmol.2023.0193
Conflict of Interest Disclosures: Dr Al-Khersan reported receiving personal fees from RegenxBio, Genentech, and EyePoint Pharmaceuticals outside the submitted work. Dr Williams reported receiving consulting fees from Allergan, Castle Biosciences, EyePoint Pharmaceuticals, Genentech, and Regeneron outside the submitted work. No other disclosures were reported.
Additional Contributions: We thank Angela R. Elam, MD, Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, Michigan, for assistance in editing this manuscript. Dr Elam did not receive compensation for her contribution. We thank the patient for granting permission to publish this information.
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