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PHOTO ESSAY
Year : 2022  |  Volume : 2  |  Issue : 2  |  Page : 567-568

Iridoschisis - A rare form secondary angle-closure glaucoma


Glaucoma Services, Mithu Tulsi Chanrai Campus, L. V. Prasad Eye Institute, Patia, Bhubaneswar, Odisha, India

Date of Submission03-Jul-2021
Date of Acceptance30-Nov-2021
Date of Web Publication13-Apr-2022

Correspondence Address:
Aparna Rao
L. V. Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Patia, Bhubaneswar, Odisha - 751 024
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1608_21

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  Abstract 


Keywords: Iridoschisis, iris degeneration, secondary angle-closure glaucoma


How to cite this article:
Pal A, Rao A. Iridoschisis - A rare form secondary angle-closure glaucoma. Indian J Ophthalmol Case Rep 2022;2:567-8

How to cite this URL:
Pal A, Rao A. Iridoschisis - A rare form secondary angle-closure glaucoma. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 May 18];2:567-8. Available from: https://www.ijoreports.in/text.asp?2022/2/2/567/342891



A 76-year-old male diagnosed with open-angle glaucoma since 8 years presented with reduced vision in the right eye. Slit-lamp examination revealed an irregularly shallow anterior chamber, peaked pupil inferotemporally in the right [Figure 1]a, and inferonasally in the left eye [Figure 1]b. There were scattered peripheral anterior synechiae (PAS) with diffuse iris stromal atrophy [Figure 2], which was more prominent inferiorly. Both eyes had irregularly scattered synechial angle closure on gonioscopy [Figure 3] with advanced glaucomatous disc damage.
Figure 1: Slit-lamp picture of the right eye (a) represents scattered iris stromal splitting (black arrows denoting) with peaked pupil at 8 o'clock, left eye (b) reflects the same features (white arrow indicates the pupil peaking inferonasally)

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Figure 2: Magnified picture of right eye inferior quadrant, black arrows indicate diffuse atrophic patches and yellow arrow shows PAS with iris stromal splitting, well visualized in the inset with high magnification

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Figure 3: Gonioscopic view of right eye inferior angle (a) indicates peripheral anterior synechiae (white arrow marking), echoes same in anterior segment optical coherence tomographic B-scan of the right eye (b) inferior irido-corneal angle, the white arrow indicating a high synechia, the inset displaying the iris configuration

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  Discussion Top


Iridoschisis, a rare form of secondary angle-closure glaucoma, usually presents as bilateral, progressive diffuse stromal splitting (or schisis), which differentiates this from primary glaucoma.[1],[2],[3] This should not be confused with other causes such as essential iris atrophy with ischemia and developmental glaucoma such as iridocorneal endothelial syndrome.[4] Management of progressive angle closure and cornea change. Progressive synechial angle closure and corneal bullae may occur by direct contact with iris strands.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Romano A, Treister G, Barishak R, Stein R. Iridoschisis and angle closure glaucoma. Ophthalmologica 1972;164:199-207.  Back to cited text no. 1
    
2.
Rodrigues MC, Spaeth GL, Krachmer JH, Laibson PR. Iridoschisis associated with glaucoma and bullous keratopathy. Am J Ophthalmol 1983;95:73-81.  Back to cited text no. 2
    
3.
Gogaki E, Tsolaki F, Tiganita S, Skatharoudi C, Demetrios B. Iridoschisis: Case report and review of the literature. Clin Ophthalmol 2011;5:381-4.  Back to cited text no. 3
    
4.
Pieklarz B, Grochowski ET, Saeed E, Sidorczuk P, Mariak Z, Dmuchoeska DA. Iridoschisis: A systematic review. J Clin Med 2020;9:3324. doi: 10.3390/jcm9103324.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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