Uveitis-Glaucoma-Hyphema Syndrome Constanze Kortuem, Daniela Suesskind, Manfred Zierhut Centre for Ophthalmology University of Tuebingen, Germany.

Uveitis-Glaucoma-Hyphema Syndrome

Constanze Kortuem, Daniela Suesskind,

Manfred ZierhutCentre for Ophthalmology

University of Tuebingen, Germany

Ocular History 80 year old Caucasian woman OS: feels pressure on eye and blurred vision

since one day seen abroad:

suspected posterior uveitis posterior synechiae vitreous cell infiltration cataract extraction with IOL (2010) YAG capsulotomy (2012)

General History

cardiac arrhythmia arterial Hypertension depression

First Presentation - Ocular Examination

VA: OD 20/25, OS 20/20 IOP: OD/OS 14/10 mmHg OS: AC cells 2+, pseudophakic, no

posterior synechiae in mydriasis, vital optic disc, CDR 0.7

OD: lens clear, no signs of intraocular inflammation, pale optic disc, CDR 0.7

Diagnosis

anterior uveitis of unclear origin

Treatment

topical corticosteroids every hour cycloplegics

Follow up – After 3 DaysOcular Examination

VA: OD 20/32, OS 20/25 IOP: OD/OS 14/14 mmHg OS:

AC cells 1+, Vitreal prolaps with hemorrhage

into the AC

Follow Up – Anterior Segment

Follow up- After 6 Days

Because of uncharacteristic ‘inflammation’ of anterior chamber, ultrasound was performed before hematological laboratory testing

Follow up – After 6 Days US

Partial posterior vitreous detachment

Follow up – After 6 Days Ultrasound Biomicroscopy (UBM)

vitreous prolaps visible between IOL and iris

Follow up – After 6 Days Ultrasound Biomicroscopy (UBM)

IOL with haptic in front of the capsular bag in the ciliary sulcus on the nasal side

IOL with haptic intracapsular on the temporal side

Diagnosis

OS: UGH-Syndrome based on

clinical findings history (IOL) ultrasound

Treatment

slow reduction of local corticosteroids relocation or IOL-extraction if recurrent

inflammation or IOP increase follow-up examinations of optic disc to

exclude low pressure glaucoma

Conclusion first descriped by Ellingson 1978

AC-IOL which had contact to uveal tissue PC-IOL nowadays:

unstable sulcus fixation zonular weekness (Pseudoexfoliatio lentis) trauma

postoperative occurence normally weeks to months may be several years

reason for intraocular exchanges in ca. 10 %