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Moinul P, Hutnik CM. Aqueous misdirection syndrome: an interesting case presentation. Clin Ophthalmol. 2015;9:183-6doi: 10.2147/OPTH.S75698.
Moinul, P., & Hutnik, C. M. (2015). Aqueous misdirection syndrome: an interesting case presentation. Clinical ophthalmology (Auckland, N.Z.), 9183-6. https://doi.org/10.2147/OPTH.S75698
Moinul, Prima, and Hutnik, Cindy Ml. "Aqueous misdirection syndrome: an interesting case presentation." Clinical ophthalmology (Auckland, N.Z.) vol. 9 (2015): 183-6. doi: https://doi.org/10.2147/OPTH.S75698
Moinul P, Hutnik CM. Aqueous misdirection syndrome: an interesting case presentation. Clin Ophthalmol. 2015 Jan 29;9:183-6. doi: 10.2147/OPTH.S75698. eCollection 2015. PMID: 25678765; PMCID: PMC4322885.
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Clin Ophthalmol. 2015 Jan 29;9:183-6. doi: 10.2147/OPTH.S75698. eCollection 2015.

Aqueous misdirection syndrome: an interesting case presentation.

Clinical ophthalmology (Auckland, N.Z.)

Prima Moinul, Cindy Ml Hutnik

Affiliations

  1. Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
  2. Ivey Eye Institute, St Joseph's Health Care, Department of Ophthalmology, University of Western Ontario, London, ON, Canada.

PMID: 25678765 PMCID: PMC4322885 DOI: 10.2147/OPTH.S75698

Abstract

OBJECTIVE: To report a case of an aqueous misdirection-like presentation in a pseudophakic patient.

DESIGN: Retrospective case review.

PARTICIPANT: An 84-year-old pseudophakic gentleman presented with bilateral blurred vision 8 years after cataract surgery. A refractive shift with shallow anterior chambers and elevated intraocular pressures were noted. No corneal edema was noted. Although aqueous suppression and topical atropine would relieve the signs and symptoms, the effect was temporary with fluctuating and variable changes in refraction, anterior chamber depth, and intraocular pressure. The presence of patent iridotomies had no effect on the fluctuations. A pars plana vitrectomy and surgical iridectomy were successful in preventing further fluctuations.

CONCLUSION: Aqueous misdirection is a form of secondary angle closure glaucoma marked by elevated intraocular pressures, myopic shift in refraction, and central shallowing of the anterior chamber. Here, a case of a pseudophakic patient experiencing bilateral and fluctuating signs and symptoms resembling aqueous misdirection is presented. Surgical intervention with a pars plana vitrectomy and iridectomy prevented further fluctuations.

Keywords: aqueous misdirection; glaucoma; pars plana vitrectomy; secondary angle closure

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