Acute glaucoma secondary to posterior scleritis uveal effusion syndrome

Abstract

AbstractPurpose: To describe an observational case of closed‐angle glaucoma secondary to uveal effusion syndrome after a first episode of posterior scleritis.Methods: Morales Meseguer University Hospital. Ophthalmology service. Uveitis section.Results: A 76‐year‐old woman presented to the emergency department with a red, painful right eye (RO) and decreased visual acuity (VA). Initial VA was light perception and intraocular pressure was 40 mmHg, presenting a narrowed chamber and corticonuclear cataract. The fundus was not assessable due to media opacity. Optical coherence tomography showed choroidal folds in the left eye, and the OD was unapproachable. B‐mode ocular ultrasound showed scleral thickening of 2 mm in both eyes and a superior temporal hematic choroidal detachment in the left eye. She was diagnosed with acute glaucoma secondary to uveal effusion after the first outbreak of posterior scleritis. In the emergency department she was treated with intravenous mannitol, acetazolamide orally and hypotensive eye drops. Acute angle‐closure glaucoma and choroidal detachment remitted under systemic steroid treatment, cycloplegic eye drops and topical hypotensive agents. After screening for pathologies associated with posterior scleritis, idiopathic origin of the condition was concluded.Conclusions: Patients with posterior scleritis may develop uveal effusion syndrome, which can lead to secondary angle‐closure glaucoma. A screening for pathologies associated with posterior scleritis (Wegener's, rheumatoid arthritis, herpes zoster, tumours, porphyria, post‐surgical or pharmacological causes) should be performed, although most cases are idiopathic. Treatment differs from glaucoma due to pupillary block, being necessary the use of systemic corticosteroids.