ABSTRACT
PURPOSE: To identify vitreopapillary tractional forces as a possible cause of optic nerve head elevation. METHODS: Case reports. Two patients aged 64 and 84 years underwent detailed ocular examination and B-scan ultrasonography. RESULTS: Both patients had a unilateral elevated optic nerve head with normal color vision, normal pupillary responses, and full kinetic perimetry. Biomicroscopic and B-scan ultrasonographic evaluation confirmed the presence of vitreopapillary traction. CONCLUSIONS: Vitreopapillary traction can cause unilateral optic nerve head elevation. The posterior hyaloid should be evaluated in patients with optic nerve head elevation.
Subject(s)
Optic Disk/pathology , Optic Nerve Diseases/etiology , Vitreous Body/pathology , Aged , Aged, 80 and over , Eye Diseases/complications , Eye Diseases/diagnostic imaging , Female , Fundus Oculi , Humans , Intraocular Pressure , Male , Middle Aged , Optic Disk/diagnostic imaging , Optic Nerve Diseases/diagnostic imaging , Optic Nerve Diseases/pathology , Ultrasonography , Vitreous Body/diagnostic imagingABSTRACT
PURPOSE: To study a patient with bilateral uveal effusions and secondary glaucoma as an initial manifestation of systemic lupus erythematosus. DESIGN: A case report. METHODS: The patient presented with bilateral uveal effusions and angle-closure glaucoma. A detailed ocular examination with ultrasonography and a comprehensive medical evaluation with laboratory testing were performed. RESULTS: The ocular examination revealed bilateral uveal effusions with angle-closure and elevated intraocular pressures. A systemic evaluation revealed bilateral pleural effusions and laboratory values consistent with systemic lupus erythematosus. After medical and laser therapy failed to lower the intraocular pressure, partial thickness sclerectomies, linear sclerostomies, and choroidal drainage were successful in controlling the glaucoma. CONCLUSIONS: Uveal effusion with secondary glaucoma can be a presenting sign for systemic lupus erythematosus. If antecedent ocular abnormalities are not present, a systemic evaluation is warranted in assessing a patient with uveal effusions and secondary angle-closure glaucoma. Partial-thickness sclerectomies, linear sclerostomies, and choroidal drainage may be effective in lowering intraocular pressure.
