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 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.