Case report
Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report
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* Corresponding author: Christopher C Teng cctengmd@gmail.com
1 Einhorn Clinical Research Center, The New York Eye and Ear Infirmary, New York, NY, USA
2 Departments of Ophthalmology, New York Medical College, Valhalla, NY, USA
3 New York University Medical Center, New York, NY, USA
4 Columbia University College of Physicians and Surgeons, New York, NY, USA
Journal of Medical Case Reports 2011, 5:221 doi:10.1186/1752-1947-5-221
Published: 17 June 2011Abstract
Introduction
We report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement. This represents a rare case in which a patient with no light perception vision was able to regain functional vision.
Case presentation
A 63-year-old Caucasian man with a 55-year history of long-standing retinal detachment after trauma presented to our facility with pain and redness, a total hyphema, no light perception vision and an intraocular pressure of 60 mmHg (right eye). He had a history of diabetes mellitus and coronary artery disease. Following anterior chamber washout, he was found to have neovascular glaucoma, for which intravitreal bevacizumab was administered. After washout and intraocular pressure control, his visual acuity improved to light perception. He subsequently underwent vitrectomy, membrane peeling, endolaser and silicone oil placement to reattach his retina, and then a second retinal reattachment procedure. Following these procedures, he had visual recovery to counting fingers vision in his right eye at five metres, complete regression of neovascularization, and intraocular pressure of 10 to 12 mmHg on one antiglaucoma medication.
Conclusion
Functional vision can be regained despite long-standing retinal detachment.