Pupillary Blocks In Uveitis Glaucoma Hyphema Syndrome: A Case Report

Uveitis Glaucoma Hyphema (UGH) syndrome results from chaffing between intraocular implant and anterior chamber structures, and it typically presents with anterior chamber inflammation, elevated intraocular pressure and recurrent microhyphema or hyphema. Herein, we report the case of a patient with atypical presentation: iridocorneal angle closure. The same patient developed reverse pupillary blook a few weeks later after surgery.

University of Bologna, Italy

A caucasian 77-years-old woman presented with iridocorneal angle closure due to a clot induced pupillary block. The bleeding was caused by rubbing between a late in-the-bag dislocated intraocular lens and the iris in pseudoexfoliative syndrome. The diagnosis of UGH was initially delayed by unusual presentation. She underwent intraocular lens (IOL) exchange and secondary IOL scleral fixation and subsequently developed reverse pupillary block. Both pupillary blocks were resolved by YAG-laser iridotomy.

This case is unique due to the occurrence of both pupillary block and subsequent reverse pupillary block in the same patient, highlighting the importance of recognizing these uncommon and atypical mechanisms in UGH syndrome.