Elsevier

Ophthalmology

Volume 105, Issue 7, 1 July 1998, Pages 1170-1172
Ophthalmology

Angle-closure glaucoma as an initial presentation of systemic lupus erythematosus

https://doi.org/10.1016/S0161-6420(98)97015-4Get rights and content

Abstract

Purpose

To study a patient with bilateral uveal effusions and secondary glaucoma as an initial manifestation of systemic lupus erythematosus.

Design

A case report.

Methods

The patient presented with bilateral uveal effusions and angle-closure glaucoma. A detailed ocular examination with ultrasonography and a comprehensive medical evaluation with laboratory testing were performed.

Results

The ocular examination revealed bilateral uveal effusions with angle-closure and elevated intraocular pressures. A systemic evaluation revealed bilateral pleural effusions and laboratory values consistent with systemic lupus erythematosus. After medical and laser therapy failed to lower the intraocular pressure, partial thickness sclerectomies, linear sclerostomies, and choroidal drainage were successful in controlling the glaucoma.

Conclusions

Uveal effusion with secondary glaucoma can be a presenting sign for systemic lupus erythematosus. If antecedent ocular abnormalities are not present, a systemic evaluation is warranted in assessing a patient with uveal effusions and secondary angle-closure glaucoma. Partial-thickness sclerectomies, linear sclerostomies, and choroidal drainage may be effective in lowering intraocular pressure.

Section snippets

Case report

A 40-year-old black woman presented with a 3-day history of decreased vision, red eyes, and retro-orbital pain. Past medical history was significant for hypertension, which was treated with a calcium channel blocker. She reported mild arthralgias, which were relieved by anti-inflammatory agents. There was no significant past ocular history.

Uncorrected visual acuity was 20/40 in both eyes. The acuity was correctable to 20/20 in both eyes with a −2.00 sphere. Applanation tensions were 64 mmHg in

Discussion

Systemic lupus erythematosus has been associated with numerous ocular disorders, including mucocutaneous diseases of the lid, Sjögren’s syndrome, conjunctivitis, episcleritis, scleritis, uveitis, retinal microangiopathy, papilledema, and other neuro-ophthalmic lesions.8, 9 Choroidopathy without secondary angle-closure glaucoma has been reported.8 We believe that this is the first report of ciliochoroidal effusions with secondary angle-closure glaucoma as an initial presentation of SLE.

References (10)

There are more references available in the full text version of this article.

Cited by (0)

View full text