A 60-year-old female presented with painful diminution of vision with nausea for past 2 days. On evaluation, best-corrected visual acuity (BCVA) was 6/9 in the right eye (RE) and finger counting at 2 m in the left eye (LE). IOP as measured by Goldmann Applanation Tonometry was 11 and 48 mmHg in RE and LE, respectively. Microcystic corneal edema with shallow AC was seen in LE. Multiple thin disintegrated iris fibrils were seen floating in the AC from 5 to 7 o'clock in RE and from 4 to 8 o'clock in LE [Figure and ]. Gonioscopy showed 180° and 360° peripheral anterior synechiae (PAS) in RE and LE [], respectively. Laser peripheral iridotomy (PI) was done in both eyes. Lens showed early nuclear sclerosis with a cup-disc ratio of 0.5:1 in RE and 0.6:1 with inferior rim thinning in LE. Corresponding superior arcuate defect was seen on visual fields in LE. She was diagnosed as a case of bilateral iridoschisis presenting as unilateral acute angle closure attack. A combination of two antiglaucoma medications (AGMs) was started in both eyes. On her 6-month evaluation, the patient had an IOP of 12 and 14 mmHg in RE and LE, respectively.
A 35-year-old female presented with bilateral inferior iridoschisis with chronic angle closure glaucoma and cataract in both eyes. RE was prephthisical eye with IOP of 6 mmHg. PI followed by prescription of 2 AGMs was done in LE. On her 6th-year follow-up, IOP was 16 mm in RE and 14 mm in LE. She was advised to undergo combined cataract and glaucoma surgery in LE.