June 06, 2013
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Eyes with dislocated lenses may be misdiagnosed with acute primary angle-closure glaucoma

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Neglected ocular history and signs of ocular trauma most commonly resulted in misdiagnosis in patients with acute angle-closure glaucoma secondary to lens dislocation, according to a study.

The retrospective study included 526 patients diagnosed with acute angle-closure glaucoma between 2003 and 2009.

All patients underwent a medical and ocular history; bilateral examination of the ocular anterior segment by slit-lamp microscopy; and bilateral assessment of anterior chamber depth, chamber angle and zonular status with ultrasound biomicroscopy.

Choice of surgical procedure was based on degree of angle closure, zonular dialysis and lens subluxation.

Study results showed 31 eyes of 31 patients (6%) had acute angle-closure glaucoma secondary to lens subluxation that was misdiagnosed as acute primary angle-closure glaucoma. These patients had a mean age of 59.3 years.

Anterior chamber depth was 1.34 mm in affected eyes and 2.27 mm in fellow eyes, which represented a statistically significant difference (P < .05).

Best corrected visual acuity improved significantly at 3 months after surgery. Mean IOP was 12.09 mm Hg without medication at final follow-up, the authors said.