Secondary glaucoma as a late complication of a primary iris stromal cyst

Abstract

An 18-year-old woman with a congenital iris stromal cyst was referred for sudden-onset increased intraocular pressure (IOP) that did not respond to medical therapy. Ultrasound biomicroscopy demonstrated synechial angle closure from 9:00 to 12:00 in addition to a large cyst occupying much of the inferior angle. After implantation of an Ahmed glaucoma valve, her visual acuity returned to baseline, and IOP normalized. Although primary iris cysts are generally stationary and have rarely been reported to cause ocular complications, secondary glaucoma can present as a rare complication of primary iris cysts. This case highlights the importance of serial examinations to monitor iris cysts and consideration of glaucoma as a late complication.

Figure 1

Clinical photograph of right eye showing stromal iris cyst in the inferior quadrant. Surgical scars are seen at the 10:00 and 2:00 limbus from attempted cyst resection at age 3 months.

Figure 2

Ultrasound biomicroscopy showing fusion of the cyst with the cornea.

Figure 3

Ultrasound biomicroscopy showing an open angle at 3:00 (A) and synechial angle closure at 12:00 (B).