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We appreciate the comments of Dr Shugar and are indebted to him for his insights. Dr Shugar's observations regarding air bubble—related angle-closure glaucoma in normal-sized eyes are enlightening and underscore the importance of monitoring air bubble size relative to anterior chamber size. Additionally, the management option described by Dr Shugar provides an expedient method of decompressing the eye in these cases and probably should be considered the first-choice method of treatment.
Flowers CW, Reynolds D, Irvine JA, Heuer DK. Pupillary Block, Angle-closure Glaucoma Produced by an Anterior Chamber Air Bubble in a Nanopthalmic Eye-Reply. Arch Ophthalmol. 1997;115(3):432. doi:10.1001/archopht.1997.01100150434027