Bilateral angle-closure attack in a COVID-19-positive patient.

Ophthalmic examination of a patient with active COVID-19 infection can be challenging. We describe a woman with active COVID-19 infection who was misdiagnosed initially as having conjunctivitis and later presented with acute angle-closure attack in both eyes. Intraocular pressure (IOP) on presentation was about 40 mmHg in both eyes. She was on multiple medications for her COVID-19 infection. A nonpupillary block mechanism of secondary angle closure was suspected and laser iridotomy was avoided. Her IOP was well controlled with medications. Due to significant cataract, phacoemulsification with IOL was performed using femto-assisted rhexis in lieu of the postdilatation IOP spike. There was good IOP control and 6/6 vision postoperatively. Bilateral angle closure of probable multifactorial cause can occur in COVID-19-positive patients.

Management of acute hydrops with pre-Descemet's deep anterior lamellar keratoplasty.

This case report describes a 23-year-old female patient who had bilateral keratoconus and a history of right eye penetrating keratoplasty who presented with acute hydrops in the left eye which did not respond to conservative management. Pre-Descemet's deep anterior lamellar keratoplasty was performed in the acute stage for management of the impending perforation with good visual outcomes.