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INTO THE DARKNESS AND SILENCE: EVISCERATION IN A DEAF-MUTE- BLIND PATIENT WITH NEGLECTED GLAUCOMA: Poster Presentation - Case Report - Resident Lumita, Ferdinand Inno; Laksmita, Yulinda Arty; Sieman, Andrew John; Iskandar, Ferdy; Paramita, Carennia; Aziza, Yulia
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/n2m27f33

Abstract

Introduction : Glaucoma can have a potentially devastating effect on patient’s vision and quality of life if not treated properly. We described a neglected glaucoma case in a deaf-mute-blind patient that leads to evisceration. Case Illustration : A 64-year-old deaf-mute female came to our emergency room with chief complaint of bloody discharge from her right eye 12 hours prior to admission with no history of trauma. Patient’s right eye has been blind for the last four years; her left eye has been nonfunctional since she was in her 30s. She went to a primary clinic during this time but did not get any diagnoses. Physical examination revealed uveal prolapse of the right eye with infiltrates around the remaining cornea; and phtisical left eye with IOP of 30 mmHg and opaque cornea. We performed evisceration with dermato-fat graft of the right eye. Discussion : Glaucoma is a challenging disease, especially in developing countries. It is difficult to diagnose due to its nature to be asymptomatic until late in the disease course. The loss of vision is painless and insidious; resulting in late diagnosis unless patients are screened for glaucoma early on. Patient in this report is particularly difficult for the caretaker since she is a deaf-mute patient; resulting in a suspected undiagnosed glaucoma that leads to evisceration and blindness. Conclusion : Glaucoma care generally necessitates routine follow-up for monitoring of disease progression and medication adjustments. Good screening system, family support, and integration of eye care into existing healthcare systems is needed for early detection to reduce blindness from glaucoma.
A case of mixed mechanism glaucoma: diagnostic and management challenges Iskandar, Ferdy; Oktariana, Virna Dwi; Aziza, Yulia
Medical Journal of Indonesia Vol. 34 No. 4 (2025): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.258092

Abstract

Mixed mechanism glaucoma occurs when secondary causes contribute to glaucoma in an eye with preexisting primary open-angle glaucoma (POAG) or primary angle-closure glaucoma. This study highlights its diagnostic and management challenges. A 63-year-old female presented with blurry vision and right eye pain for 2 months. She had undergone cataract surgery in the right eye 6 months earlier and developed elevated intraocular pressure (IOP) afterward. Her visual acuity in the right eye was hand movements, and IOP was 34 mmHg despite medications. Examination revealed signs of uveitis, leading to a diagnosis of secondary glaucoma. A glaucoma drainage device (GDD) was implanted, successfully controlling IOP. Follow-up revealed POAG signs in the left eye, prompting a revised diagnosis of mixed mechanism glaucoma in the right eye. GDD implantation was effective, but continued monitoring remained essential to maintain the target IOP.