Arshad Shaikh.
Glaucomatocyclitic Crisis.
Pak J Ophthalmol Jan ;15(2):82-4.

A 37-year-old male doctor of Abbasi Shaheed Hospital presented to the eye OPD and requested the doctor. in the department to check the pressure of his eyes for he had blurring of vision in the left eye and he had also witnessed halos around lights. The intraocular pressure (IOP) was recorded with the Schiotz tonometer to be around 40mm Hg at that time. The doctor was put on tab. diamox and pilocarpine 2% eye drops. The next day the pressure was checked to be normal with the Schiotz and applanation tonometers. Biometry showed 25.5mm axial length and keratometric readings were 44.50 and 45.0 in both eyes. The patient had myopia of -5.0 diopters with -0.5 diopter cylinder at 180 degree axis. The doctor was advised to stop systemic diamox and to continue with pilocarpine eye drops. On the third day the doctor again came with blurring of vision and halos. The IOP was 40mm Hg in the left eye with applanation. The eye in the beginning had no ciliary congestion but the ciliary congestion appeared 1/2 hr later. Treatment was initiated with glycerin 50 ml scat, tab diamox, pilocarpine eye drops and tab ponstan was also given. In the evening, when the IOP had settled down, slit-lamp examination revealed a few keratic precipitates. Gonioscopy revealed completely open angles. Visual acuity became normal after 6 hrs. A diagnosis of glaucomatocylitic crisis was made and IOP wag corrected by medical means and topical steroids were started to control the associated iridocyclitis. Systemic investigations revealed ESR of 50mm Ist hour. Other investigations were normal. History revealed that the patient was prediabetic and his mother had attacks of angle-closure glaucoma. His father had neurofibromatosis and was on antidepressants for the last 26 years for manicdipressive pychosis. The patient himself was under a lot of tension and had psychosomatic disorders like neck pains. back pains, mild hypertension and asthma in winters. He also complained of recurrent gastritis and aphthous ulcers in the mouth. He had vasomotor rhinitis, psoriasis and allergies to beef, mutton and pulses.

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