|Year : 1982 | Volume
| Issue : 2 | Page : 113-114
A case of bilateral primary acute congestive glaucoma
Burdwan Medical College & Hospital, Burdwan, West Bengal, India
P R Chatterjee
Burdwan Medical College & Hospital, Burdwan, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chatterjee P R. A case of bilateral primary acute congestive glaucoma. Indian J Ophthalmol 1982;30:113-4
Primary acute congestive glaucoma is not an uncommon disease in our country. Primary closed angle glaucoma constitutes about 15-20% of all glaucoma diagnoses. It is well documented that primary angle closure glaucoma is a bilateral disease, although symptoms usually start unilaterally and the second eye is eventually involved in high percentage of cases within a period of five years, particularly when untreated, and even if treated prophylactically with miotics. But acute congestive glaucoma occurs in both eyes at a time is extremely rare. Recently, we came across a case of bilateral acute congestive glaucoma and is being reported of its rarity.
| Case report|| |
One female Hindu widow of 45 years was brought to Eye O.P.O. with sudden severe pain, redness and marked dim vision in both eyes at a time for the last three days. These symptoms started at evening and were associated with severe headache and vomiting. There was no history of similar attack before or seeing rainbow halos in either of the eyes. There was no history of putting any drops or ointment into the eyes or taking or getting any drugs orally or parenterally. The patient took aspirin tablet by mouth for her severe pain and headache.
Examinations revealed that in both eyes, lids-swollen ; conjunctiva congested; both superficial and deep congestion L>R; cornea steamy and oedematosus L>R and corneal sensation impaired in both eyes; anterior chamber-shallow L>R ; pupil-vertically oval and not reacting to light: iris-just visible through hazy cornea ; fundus-not visible. Visual acuity-right eye hand movements very close to face and left eye only projection of rays (P.R.). Tension was digitally very high-stony hard L>R.
Systemic examinations nothing contributory. The patient was admitted and kept under medical treatment immediately-with
(i) Hot fomentation both eyes thrice daily.
(ii) Pilocarpine Nitrate 2,o Drop-One drop four hourly in both eyes.
(iii) Tab. Diamox (250 mg)-Two tabs. Stat and one tab. eight hourly.
(iv) Liquid Pot. chlor-i oz thrice daily.
(v) Locally Sofracort eye drops-Onedrop thrice daily in both eyes.
(vi) Tab. Aspirin-for pain and Tab.Gardinal for sleep.
After 24 Hours with aforesaid treatment, her intraocular tension came down, appreciable congestion and redness of the conjunctiva were less; corneal oedema was less and both eyes revealed cataractous changes in lens, left more than right. Treatment was continued for two days more and Gonioscopy was done on next day showing Grade I to lI according to Shaffer in both eyes with gonio synechiae. Two pillars iridencleisis operation done on fifth day after onset of medical treatment in both eyes at same siting. Patient was discharged on seventh post operative day. At the time of discharge, both eyes were quite, well formed anterior chamber, good subconjunctival bleb and vision right eye 3/60 and left eye T/60 uncorrected. The visual acuity at six weeks after discharge in right eye was 6/12 aided and in left eye was 6/60 aided (due to the position of the cataract probably affecting the nodal point of left eye).
In the present case it is obvious that the patient of 45 years Hindu widow developed suddenly signs and symptoms of bilateral acute congestive glaucoma at evening in the last week of May without relevant history of such a condition in either of the eyes before. There is no history of taking any drugs parenterally or orally or using any drops or ointments in the eyes.
| Summary|| |
A case of primary acute congestive glaucoma occurring in both eyes at a time, has been reported.
| Acknowledgement|| |
We are very much grateful to the Superintendent, Burdwan Medical College and Hospital, Burdwan for permitting us to publish this paper.
| References|| |
Duke-Elder, S., 1969, System of Ophthalmology, Vol, X1, Pages 563-566, 589 and 621, Henry Kimpton London.
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Shaffer 1972 Quoted by Suger, H.S., Modern Ophthalmology, Second Edition, Edited by Sorsby, A pages- 622.
Suger, H.S. 1972 Modern Ophthalmology, Second Edition, Edited by Sorsby, A-Pages 614, 617 and 622.