Primitasari, Yulia
Department Of Ophthalmology, Faculty Of Medicine, Universitas Airlangga/ Dr.Soetomo General Hospital, Surabaya

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Journal : Vision Science and Eye Health Journal

A Rare Case of Chronic Primary Angle-Closure Glaucoma in a Young Woman with Coexisting Pathologic Myopia Ni Putu Ayu Reza Dhiyantari; Nurwasis Nurwasis; Evelyn Komaratih; Yulia Primitasari
Vision Science and Eye Health Journal Vol. 1 No. 1 (2021): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1436.726 KB) | DOI: 10.20473/vsehj.v1i1.2021.10-16

Abstract

Introduction: Primary Angle-Closure Glaucoma (PACG) is usually present in adults older than forty and is more common in hyperopic eyes. Angle-closure is usually related to structural or developmental ocular abnormalities in young individuals. Case presentation: We presented a rare case of PACG in a 32 years old woman with pathologic myopia of -23.0 RLE. The chief complaint was blurring of the right eye three months before the visit. Right eye Intraocular Pressure (IOP) was 30mmHg-38mmHg despite treatment with three intra-ocular pressure-lowering agents. Axial length was 32.36 mm and 31.19 mm RLE. Anterior chamber depth was 2.36 mm and 2.60 mm RLE. Lens thickness was 5.07 mm and 5.40 mm RLE. Signs of GON and pathologic myopia were found in both eyes. GON was present asymmetrically (0.9 and 0.6 RLE), with the myopic crescent as well as baring and peripapillary atrophy. The optic disc was slightly tilted with the myopic crescent. There was also a marked sign of retinal pigment epithelium thinning and attenuation along with myopic chorioretinal atrophy. Conclusions: PACG in a young myopic individual is challenging to diagnose because myopia and glaucoma share similar optic nerve head pathology. Comprehensive examinations including gonioscopy, biometry, and OCT may confirm the diagnosis. In the presented case, angle-closure was caused by thick lenses and a shallow anterior chamber, along with excessively long axial length. Primary angle-closure at a young individual with myopic eyes is highly uncommon. Nonetheless, clinicians should always consider glaucoma even in the presence of high axial length and myopic fundus.
The Difficulties of Trabeculectomy in a Primary Angle-Closure Glaucoma Patient Herdina Ramadhani; Nurwasis Nurwasis; Yulia Primitasari; Evelyn Komaratih
Vision Science and Eye Health Journal Vol. 1 No. 2 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5082.62 KB) | DOI: 10.20473/vsehj.v1i2.2022.38-44

Abstract

Introduction: Trabeculectomy is an incisional surgery for glaucoma patient. Performing trabeculectomy in primary angle-closure glaucoma (PACG) is quite difficult. Caution is needed for the occurrence of flat anterior chamber (FAC) and malignant glaucoma. We present a case management of trabeculectomy in a PACG patient. Case presentation: A 52-year-old male had blurred vision in his left eye since one year ago. The patient felt left visual field narrowing since eight months ago. Patient had type 2 diabetes mellitus. Visual acuity on the left eye was 5/7.5. Intraocular pressure (IOP) increased (29 mmHg). Gonioscopy showed closed angle and peripheral anterior synechiae. Glaucomatous optic neuropathy was found with C/D ratio value of 0.9 and superior-inferior RNFL thinning on optical coherence tomography (OCT). Anterior segment OCT revealed shallow anterior chamber depth (ACD) 2.54 mm. The right eye visual acuity was 5/5, normal IOP, and shallow ACD (2.66 mm). Patient was underwent left eye trabeculectomy. Postoperatively, left eye anterior chamber and bleb were formed. He had normal IOP without glaucoma medications. Conclusions: Trabeculectomy is a surgical procedure for glaucoma. Close monitoring is required to avoid the risk of postoperative FAC and malignant glaucoma in PACG.
Bilateral Pigment Dispersion Syndrome (PDS) in a Young Female Patient Karunika, Anindya Ramadian; Komaratih, Evelyn; Nurwasis; Primitasari, Yulia
Vision Science and Eye Health Journal Vol. 4 No. 2 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i2.2025.55-59

Abstract

Introduction: Pigment dispersion syndrome (PDS) is characterized by pigment accumulation in the anterior chamber and a concave peripheral iris. Many PDS patients are not diagnosed until the disease has progressed to pigmentary glaucoma or other visual problems. Since glaucoma is the primary cause of permanent blindness globally, it is crucial to perform a thorough examination on patients with PDS to identify early indicators of pigmentary glaucoma (PG). Case Presentation: A 17-year-old female presented to the ophthalmology outpatient unit with eye pain and headache. The intraocular pressure (IOP) in the right eye was 30 mmHg, while in the left eye, it was 20.5 mmHg due to the peripheral iris' concavity and heavy pigmentation in the trabecular mesh in both eyes. The patient was diagnosed with pigment dispersion syndrome in both eyes and was given timolol maleate 0.5% eye drops. A follow-up examination revealed a decrease in the IOP and pain. Conclusions: Many young PDS patients go undiagnosed, and those with glaucoma are misdiagnosed as having juvenile onset glaucoma or primary open angle glaucoma. When high IOP is seen in young myopic patients, a thorough evaluation of the anterior segment is required. The patient should be aware of the progression of PG, and regular follow-up is recommended.
Gonioscopy in Practical Ophthalmology: A Comprehensive Review of Its Principles, Practice, and Clinical Relevance Widyati, Dyah Ratri; Primitasari, Yulia; Komaratih, Evelyn; Nurwasis
Vision Science and Eye Health Journal Vol. 5 No. 1 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v5i1.2025.39-45

Abstract

Introduction: Gonioscopy is a vital ophthalmic examination that enables direct visualization of the anterior chamber angle, which is primarily essential for glaucoma diagnosis and management. Despite being the gold standard, it remains underutilized in clinical practice. Purpose: This review synthesizes current knowledge on gonioscopy's principles, techniques, and clinical relevance, emphasizing its predominant role in glaucoma while acknowledging its broader diagnostic utility. Reviews: Gonioscopy allows detailed assessment of angle structures, which are crucial for distinguishing between open-angle and angle-closure glaucoma and for detecting secondary glaucomas such as neovascular or pigment dispersion glaucoma. Its dynamic indentation capability uniquely differentiates appositional angle closure from permanent synechiae, unlike static imaging modalities. The review highlights historical evolution, technique nuances, indications, and technological advancements, including digital imaging tools. Gonioscopy guides clinical decision-making by identifying angle pathology that influences interventions like laser peripheral iridotomy or surgical procedures. Challenges include operator skill requirements and patient cooperation, with underuse reported even among surgical candidates. Guidelines advocate routine gonioscopic examination for glaucoma suspects. Conclusions: Gonioscopy remains indispensable, especially in glaucoma care, providing dynamic, real-time anatomical insights that cannot be replaced by imaging alone. Improving clinical training and integration into routine practice is critical to optimize early detection, accurate diagnosis, and tailored management of glaucoma and other anterior segment disorders.