Chronic uveitis encompasses a heterogeneous group of diseases, many of which being idiopathic in origin and associated with a high incidence of vision-threatening complications. This case report portrays management challenges associated with uveitic glaucoma and complicated cataract with occlusion pupillae associated with neovascularization.
A 38-year-old male presented with gradual visual loss and recurrent pain in the right eye, diagnosed as chronic anterior uveitis of idiopathic origin, with uveitic glaucoma, complicated cataract, and occlusion pupillae with iris bombe. Medical management and laser peripheral iridectomy (PI) were performed before the patient reported to us, to lower IOP, led to temporary control of IOP. We found neovascularization of the iris and pupillary membrane with obliteration of iridotomies. Nd: YAG synechiolysis was performed repeatedly. Finally under treatment, after 3 months of quiescence of the eye, Phacoemulsification with synechiolysis and IOL implantation was done. Postoperative inflammation and cystoid macular edema were controlled with oral steroids. This case highlights all the complications of the disease which were successfully managed. Use of steroids pre and post-operatively, meticulous planning and implementation can improve visual outcome in these types of cases.