A 26-year-old male with a history of hypertensive herpes simplex uveitis in his left eye.
The corrected visual acuity in the right eye was 1 and in the left eye was 0.05.
The ocular pressure is 14 mmHg in the right eye and 55 mmHg in the left eye with oral treatment with acetazolamide and topical treatment with thymolol and brimonidine.
The anterior segment only shows corneal oedema in the left eye.
Papillary explantation was 0.2 in right eye and 0.9 in left eye.
Since it was impossible to control intraocular pressure, a trabeculectomy was performed in the left eye using mitomycin C (0.4 mg/ml for 2 minutes).
In the immediate postoperative period, a diffuse blister with a narrow anterior chamber (atamia grade 1) appears due to excess of tapering.
Intraocular pressure is 15 mmHg.
At the bottom of the eye, multiple round and deep hemorrhages are evident, affecting the posterior pole, papilledema with decreased papillary secretion index before surgery and macular edema.
The patient does not report a worse visual acuity in the left eye, however, it is objective that the vision has decreased from fingers to two meters.
1.
This clinical picture raises the suspicion of dementia due to depression.
A study was conducted in the Uveitis Unit to rule out other causes of colitis, all of which were negative.
Clinically, venous occlusion and the possibility of previous Valsalva maneuver are also ruled out.
Postoperative treatment consisted of topical dexamethasone and atropine and oral famicide prophylaxis.
The depth of the anterior chamber is normalized in the second week.
In the first two months the postoperative course is satisfactory, maintaining intraocular pressures of 10 to 14 mmHg.
Bleeding located in the posterior pole, papilledema and macular edema returned spontaneously during this time, reaching a visual acuity of 0.125.
