A novel presentation of atypical bilateral Chandler syndrome with an insight into management

Abstract

We report an atypical presentation of bilateral Chandler's syndrome with secondary angle-closure glaucoma. Right eye (RE) AS-OCT showed higher lens vault. Left eye (LE) had decompensated cornea. Intraocular pressure (IOP) in RE was 18–20 mm Hg on four topical glaucoma medications. RE cup-disk-ratio was 0.8–0.9:1. Specular and confocal microscopy aided in diagnosis. As trabeculectomy had poor prognosis (due to increased lens vault), RE phacoemulsification was done in the first stage. Postoperatively IOP in the RE was 14 mm Hg on topical glaucoma medications at 3 months follow-up. Parameters like corneal status, lens vault and IOP control must be taken into account before planning for filtering surgery.