ICE syndrome with secondary angle closure glaucoma

  

A patient presented to the Emergency Department with one day of right eye pain and blurry vision. She was noted to have decreased visual acuity in the right eye of 20/400 with highly elevated intraocular pressure at 50. Visual acuity and intraocular pressure measurements were normal in the fellow eye. On exam, she had marked corectopia, polycoria, and stretch holes of the iris, as well as significant corneal edema. The appearance of the fellow eye was normal. The presentation and clinical findings of this patient confirmed a diagnosis of ICE syndrome. The patient was treated with medical therapy but ultimately needed glaucoma drainage implant to adequately reduce intraocular pressure. The treatment course was complicated by occlusion of the glaucoma drainage implant requiring revision of the implant and removal of the cataract. The patient's intraocular pressures have been well-controlled since.

Presentation Date: 09/12/2024

Issue Date: 10/10/2024