Unilateral acute secondary angle-closure glaucoma in active thyroid eye disease

Abstract

<br>Thyroid eye disease (TED) is the most common and disfiguring orbital disease in adults. This complex condition is characterized by autoimmune-mediated inflammation of the orbital soft tissues, extraocular muscles, and eyelids. Majority of those with TED have autoimmune hyperthyroidism (Graves disease), but rarely patients can have hypothyroidism or normal thyroid function. Association of TED with open-angle glaucoma has been reported widely, whereas its association with angle-closure glaucoma has been sparsely reported as case reports. We report two instances of secondary angle-closure glaucoma (SACG) in patients with active TED, with focus on clinical presentation, diagnostic challenges, and presumed mechanisms of angle closure.<br>