Unusual case of angle closure glaucoma in a patient with neurofibromatosis type 1

Case Reports in Ophthalmology
Flavio MantelliAlessandro Lambiase

Abstract

We report the case of a 29-year-old female patient who presented with an acute onset of anisocoria, blurred vision, nausea and severe left-sided headache. There was no history of trauma, drug abuse, or instillation of topical mydriatic compounds. The ocular history was negative for similar events. On presentation, her visual acuity was 0.2 in the left and 1.0 in the right eye with a +2.5 dpt sph. correction. Slit-lamp examination demonstrated a shallow anterior chamber as well as the presence of iris nodules in both eyes. These nodules were identified as Lisch nodules as the patient referred to the previous diagnosis as being neurofibromatosis type 1. A third nerve palsy was considered, but a brain MRI showed normal results. Her ocular motility was normal, but the left pupil was mydriatic and poorly reacting to light, with an associated raised intraocular pressure (IOP) of 38 mm Hg. An examination of the fellow eye was normal, with the IOP measuring 18 mm Hg. Gonioscopy of the right eye showed a narrow angle. On further anamnestic investigation, the patient revealed that the pain and the blurred vision begun in the morning while she was helping her mother in the garden. Finally, after showing the patient a picture of Datura flo...Continue Reading

Citations

Oct 10, 2015·BioMed Research International·Solmaz AbdolrahimzadehSanti Maria Recupero
Aug 7, 2016·Journal of Ophthalmology·Solmaz AbdolrahimzadehAlessandro Lambiase
Aug 29, 2018·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·R WardehW Sekundo

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