A woman in her early 30s presented to our institution’s emergency department after assault with an alkali substance. On examination, she had severe bilateral chemical keratoconjunctivitis with perilimbal whitening, for which she received amniotic membrane placement and allogeneic limbal epithelial transplantation. She subsequently developed cataracts, corneal opacification, and progressive elevation in intraocular pressure, which was unresponsive to medical management. Given the impaired visualization, ultrasound biomicroscopy was performed to assess the iridocorneal angle and demonstrated peripheral anterior synechiae in both eyes with 360° iridoschisis in the left eye (Figure). A glaucoma drainage implant was subsequently inserted in the left eye without complication with improved control of intraocular pressure.
Swaminathan SS, Cavuoto KM, Chang TC. Iridoschisis in Angle-Closure Glaucoma Associated With Alkali Burn. JAMA Ophthalmol. 2017;135(9):e172313. doi:10.1001/jamaophthalmol.2017.2313
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