Tanito Masaki, Ichioka Sho, Ida Chisako, Ohtani Hinako, Takagi Keigo, Yoshida Yuto, Tsutsui Aika
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, JPN.
Cureus. 2025 May 27;17(5):e84917. doi: 10.7759/cureus.84917. eCollection 2025 May.
We report a case of acute intraocular pressure (IOP) elevation caused by pupillary occlusion in a Japanese man in his 90s. The patient presented with a left frontal headache and vomiting, and ophthalmologic evaluation revealed marked IOP elevation, a shallow anterior chamber, and pupillary membrane formation obscuring the lens. While anterior segment optical coherence tomography (AS-OCT) was unable to confirm the lens position, ultrasound biomicroscopy (UBM) clearly demonstrated the absence of lens displacement or intraocular mass. Yttrium aluminum garnet (YAG) laser membranotomy promptly deepened the anterior chamber and lowered IOP, followed by successful cataract surgery. Differentiation from pupillary seclusion, another cause of secondary angle closure, is critical, as it requires distinct therapeutic approaches. This case highlights the diagnostic and therapeutic considerations in managing rare causes of acute glaucoma and serves as an instructive example for ophthalmology trainees.
我们报告了一例90多岁日本男性因瞳孔阻滞导致急性眼压升高的病例。患者出现左侧额部头痛和呕吐，眼科检查发现眼压显著升高、前房浅以及覆盖晶状体的瞳孔膜形成。虽然眼前节光学相干断层扫描（AS-OCT）无法确定晶状体位置，但超声生物显微镜检查（UBM）清楚地显示晶状体无移位或眼内肿物。钇铝石榴石（YAG）激光膜切开术迅速加深了前房并降低了眼压，随后白内障手术成功。与瞳孔闭锁（继发性房角关闭的另一个原因）进行鉴别至关重要，因为这需要不同的治疗方法。该病例突出了在处理急性青光眼罕见病因时需考虑的诊断和治疗要点，为眼科实习生提供了一个有指导意义的范例。
