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Abstract #19285 Published in IGR 9-3
Aspergillus-induced malignant glaucoma
Jain V; Maiti A; Shome D; Borse N; Natarajan SCornea 2007; 26: 762-763
PURPOSE: To report a case of Aspergillus flavus-induced keratomycotic malignant glaucoma. METHODS: A 48-year-old woman presented with a severe corneal ulcer. She had received topical steroids for 10 days before presentation. RESULTS: Microbiological studies revealed A. flavus as the offending pathogen. Nonresponsive high intraocular pressure with associated shallow anterior chamber was present. With a diagnosis of keratomycotic malignant glaucoma, the patient underwent therapeutic keratoplasty with cataract extraction with posterior chamber wash. However, there was a recurrence of malignant glaucoma in the postoperative period. Patient underwent limited pars plana vitrectomy. CONCLUSIONS: Keratomycotic malignant glaucoma is a rare complication of severe fungal ulcer. We believe that the use of topical steroids in this case probably led to increased fungal penetration, with the formation of a lens-iris fungal mass and subsequent malignant glaucoma. Nonresponse to medical therapy warrants urgent surgical intervention. To the best of our knowledge, Aspergillus-induced keratomycotic glaucoma has never been reported previously. This report also highlights that therapeutic keratoplasty with cataract extraction alone may not be sufficient for management of such cases, and a limited pars plana vitrectomy may be needed.
Dr. V. Jain, Department of Cornea and External Diseases, Aditya Jyot Eye Hospital Pvt. Ltd., P. No. 153, Rd. No. 9, M. Par. Rd., Wadala, Mumbai 400031, India. docvandanajain@rediffmail.com
Classification:
9.4.2.5 Other (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera)
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
