Abstract:

To summarize the clinical and UBM morphological characteristics of 4 cases of primary angle closure glaucoma (PACG) with acute onset, who were well treated by application of compound tropicamide eye drops, in Eye Hospital of Wenzhou Medical University during a period from 2014 to 2016. All of these 4 patients were men, aged from 65 to 71 years old, including 2 cases of acute PACG and 2 cases of chronic PACG (3 cases of binoculus, 1 case of monocular eye). UBM showed that there were 2 cases with simple pupillary block, and 2 cases with pupillary block combined with anteriorly located ciliary body. The intraocular pressure were not controlled with more than 3 kinds of antiglaucoma drugs, even increased by dripping pilocarpine, but all the cases progressively dropped to below 21 mmHg in 3-15 hours while reversing to compound tropicamide. Among them, with no obvious ciliary block or lens subluxation, anterior chamber angle which were opened widely ≥ 180 ° before acute attack and entirely closed while attacking, opened again about 90°-360° after mydriasis accordantly with the open positions before acute attack. More researches are needed for indications of mydriatic treatment for PACG patients with acute onset. (Ophthalmol CHN, 2018, 27: 75-79)

Key words: primary angle closure glaucoma, pupillary block, mydriasis