Abstract
An adult presented to the glaucoma clinic to establish follow-up for ocular hypertension in both eyes. Her best-corrected visual acuity was 20/20 in both eyes and intraocular pressures were 28 mmHg in the right eye and 24 mmHg in the left eye. She was using dorzolamide-timolol and latanoprost in both eyes on presentation. On gonioscopy her angle was narrow in both eyes with appositional angle closure without peripheral anterior synechiae. Her anterior chamber was deep and quiet, and she had an early nuclear sclerotic cataract in both eyes. She underwent bilateral laser peripheral iridotomies and postoperatively had elevated intraocular pressures of approximately 40 mmHg in both eyes immediately afterward. Her elevated intraocular pressures persisted despite patent iridotomies bilaterally and while on the maximum tolerated medical eye pressure lowering therapy. An ultrasound biomicroscopy study was performed which demonstrated findings consistent with plateau iris syndrome bilaterally. She underwent argon laser peripheral iridoplasty in the left eye which resulted in opening of the angle to scleral spur, however, her IOP was still mildly elevated in that eye postoperatively. The patient then underwent uncomplicated cataract surgery in the right eye which resulted in opening of the angle to scleral spur and control of her IOP on 2 agents.
Presentation Date: 04/10/2025
Issue Date: 04/10/2026
