Angle Recession in Traumatic Hyphema: A Case Report

Abstract

Introduction: Ocular trauma is the one of the primary causes of unilateral vision impairment. It can damage the trabecular meshwork, resulting in post-traumatic glaucoma. Case Report: A 26-years old male complained pain and blurred vision in right eye in the last 4 days prior. Patient was hit by shuttlecock 6 days ago. Right eye visual acuity was hand movement. The intraocular pressure was 50,6 mmHg. There was minimal coagulum in one-third of anterior chamber volume. The anterior chamber was deep with middilated pupil. Patient was given loading CAI and hyperosmotic agent, topical β blocsa Bker, oral and topical steroid, and anti-fibrinolytic agent. First day of treatment, IOP was decreased to 11,2 mmHg. Third day of treatment, funduscopy showed hyperemic optic disc and gonioscopy showed widening of ciliary body band almost 180 degrees. Then, on the fifth day the visual acuity became 5/5 with 20 mmHg IOP. Discussion: Hyphema caused by ocular blunt trauma is typically the consequence of a tear in the iris or ciliary body, which damages the major arterial circle and its branches. Angle recession in this case was treated conservatively without drugs and the IOP remained stable. On gonioscopy, angle recession is observed as an expansion of the ciliary body band. It has been shown that angle recession glaucoma can develop within first few weeks to years after trauma. Conclusion: Ocular blunt trauma can induce elevated IOP due to inflammation, tear in iris or ciliary body and hyphema. Early diagnosis and prompt treatment can prevent irreversible optic nerve damage.