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Year : 2023  |  Volume : 3  |  Issue : 2  |  Page : 584-585

Vogt's triad – Do we find the triad all the time?

Glaucoma and Anterior Segment, Pushpagiri Vitreoretina Institute, Hyderabad, Telangana, India

Date of Submission01-Oct-2022
Date of Acceptance17-Dec-2022
Date of Web Publication28-Apr-2023

Correspondence Address:
Shabana Bharathi
Consultant, Glaucoma and Anterior Segment, Pushpagiri Vitreoretina Institute, Hyderabad, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJO.IJO_2511_22

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Keywords: Acute primary angle-closure attack, glaucomflecken, Vogt's triad

How to cite this article:
Bharathi S. Vogt's triad – Do we find the triad all the time?. Indian J Ophthalmol Case Rep 2023;3:584-5

How to cite this URL:
Bharathi S. Vogt's triad – Do we find the triad all the time?. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Jun 2];3:584-5. Available from: https://www.ijoreports.in/text.asp?2023/3/2/584/374946

Vogt is a very familiar word in ophthalmology and there are several clinical entities linked with this word. Vogt's triad is defined in glaucoma and is often related to a previous acute angle-closure attack.[1] The triad is named after the Swiss Ophthalmologist Alfred Vogt, who first described glaucomflecken, following acute glaucoma.[2] Interestingly, one may find the term Vogt's triad described outside ophthalmology, in tuberous sclerosis to the commonly known acronym epilepsy, low intelligence and adenoma sebaceum (EPILOA).[3]

A 60-year-old female patient presented with sudden-onset headache and right eye pain of 3 days duration. Her right eye vision was counting fingers at 1 m, and intraocular pressure was 62 mmHg. The affected eye was congested and had corneal edema, shallow anterior chamber, mid-dilated fixed pupil, and glaucomflecken [Figure 1]. A 63-year-old female patient presented with a past history of acute angle-closure attack in the left eye 2 years ago. Left eye vision was hand movements close to face. Slit-lamp examination showed a shallow anterior chamber, mid-dilated fixed pupil, iris atrophic patches, and absence of glaucomflecken [Figure 2]. The left eye intraocular pressure was 20 mmHg with topical medications. The fundus examination revealed disk pallor with total cupping.
Figure 1: Slit-lamp images (right and left) showing shallow anterior chamber, mid-dilated pupil, and glaucomflecken. Images were taken after the immediate reduction of intraocular pressure

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Figure 2: Slit-lamp image of the eye with a past attack of acute angle closure with mid-dilated pupil, iris atrophic patches, and no glaucomflecken

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  Discussion Top

The above description is about two patients who had acute primary angle-closure attack. But akin to the first patient with acute presentation, iris atrophy, which is a part of the triad, is rarely seen as it is a late feature that develops with time. However, when the patient presents at a later date with a past history of acute primary angle-closure attack, one may or may not be able to find all the features comprising the triad. The second patient though had such a past history, had no identifiable glaucomflecken, and hence no triad. The same holds true about the triad when the affected eyes are subjected to cataract surgery.

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.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Khurana AK. Comprehensive Ophthalmology. 4th ed. New age international (P) Limited Publishers; 2007.  Back to cited text no. 1
Gitter KA, Harris LS, Galin MA, Slusher MM. The post congestive triad of angle-closure glaucoma. Am J Ophthalmol 1969;67:540-2.  Back to cited text no. 2
Goodrick S. The road to Vogt's triad. Lancet Neurol 2015;14:690.  Back to cited text no. 3


  [Figure 1], [Figure 2]


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