A 55-year-old female presented with BCVA of 6/18 in RE and 6/24 in LE. IOP was 18 and 20 mmHg, respectively. AC was shallow in both eyes with Relative Afferent Pupillary Defect in LE. Iridoschisis fibrils were seen from 3 to 5 o'clock position in RE and 4–8 o'clock position in LE. Gonioscopy showed 360° PAS in LE with occludable angles in RE. Lens showed nuclear sclerosis Grade 3 in both eyes with a cup-disc ratio of 0.5:1 and 0.9:1 with no rim >180° in RE and LE, respectively. She also has dot blot hemorrhages in all quadrants with macular edema in LE. She was diagnosed as a case of bilateral iridoschisis with unilateral advanced angle closure glaucoma and central retinal vein occlusion in LE and primary angle closure suspect in the fellow eye. She underwent phacotrabeculectomy with mitomycin C with intraocular lens (IOL) implantation following intravitreal avastin in LE. Laser PI was done in RE. She had an IOP of 12 and 10 mmHg on her 6th-month follow-up in RE and LE, respectively. The iris tissue from the iridoschisis site as well as the iridectomy site was sent for histopathology evaluation which showed collagen fibrils were disproportionately less obvious throughout the stroma with chronic nonspecific inflammatory cells in the iridoschisis iris tissue stroma as compared to the iridectomy iris tissue [Figure and ].
A 23-year-old male presented for routine eye checkup with an IOP of 29 and 26 mm in RE and LE, respectively. On ocular evaluation, iridoschisis was present from 12 to 3 o'clock position in RE and multiple iridoschisis fibers were present at 6, 7, 10, and 11 o'clock in LE. Gonioscopy showed open angles in both eyes. Fundus evaluation showed a cup-disc ratio of 0.6:1 with bipolar thinning in both eyes with corresponding field defects. He was diagnosed as a case of iridoschisis with bilateral juvenile open angle glaucoma. The patient was started on 3 AGMs. On 5th-year follow-up, IOP was 14 mm in both eyes.