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Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report

AIM: Herein, we report a case of a 55-year-old male who presented with intermittent acute-on-chronic angle-closure glaucoma triggered by sexual excitation. BACKGROUND: Sexual excitation is an uncommon cause of pupillary block and angle closure attack. CASE DESCRIPTION: A 55-year-old male with a hist...

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Autores principales: Popovic, Marko, Schlenker, Matthew B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647822/
https://www.ncbi.nlm.nih.gov/pubmed/31354207
http://dx.doi.org/10.5005/jp-journals-10028-1259
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author Popovic, Marko
Schlenker, Matthew B
author_facet Popovic, Marko
Schlenker, Matthew B
author_sort Popovic, Marko
collection PubMed
description AIM: Herein, we report a case of a 55-year-old male who presented with intermittent acute-on-chronic angle-closure glaucoma triggered by sexual excitation. BACKGROUND: Sexual excitation is an uncommon cause of pupillary block and angle closure attack. CASE DESCRIPTION: A 55-year-old male with a history of myopic laser in situ keratomileusis (LASIK) presented with a volatile intraocular pressure (IOP) and blurred vision over the last seven years. He was particularly symptomatic following sexual excitation. Examination revealed an IOP of 36 mm Hg and best-corrected vision of 20/80 OD, with bilateral closed angles and a double hump sign on gonioscopy. There were advanced glaucomatous changes OD and mild-to-moderate changes OS on optical coherence tomography. Following an exploration of potential options, it was chosen to proceed with OD lens-based surgery, goniosynechialysis and endocyclophotoplasty. During OD recovery, the patient reported an episode of visual blurring OS secondary to sexual excitation, which was consistent with pupillary block and angle closure attack on examination. Initially managed with acetazolamide and laser peripheral iridotomy, he eventually underwent the same surgical procedure OS as for OD. Over 1-year of follow-up, he has achieved a stable IOP and excellent visual acuity bilaterally. CONCLUSION AND CLINICAL SIGNIFICANCE: This case highlights the importance of a thorough history, with the understanding that sexual excitation can precipitate angle-closure glaucoma. Gonioscopy must be performed even in the setting of myopia and a deep anterior chamber, and the double hump sign must be assessed. Appropriate education surrounding the risks of sexual activity in angle closure suspects is advised. HOW TO CITE THIS ARTICLE: Popovic M, Schlenker MB. Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report. J Curr Glaucoma Pract 2018;12(3):142-144.
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spelling pubmed-66478222019-07-26 Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report Popovic, Marko Schlenker, Matthew B J Curr Glaucoma Pract Case Report AIM: Herein, we report a case of a 55-year-old male who presented with intermittent acute-on-chronic angle-closure glaucoma triggered by sexual excitation. BACKGROUND: Sexual excitation is an uncommon cause of pupillary block and angle closure attack. CASE DESCRIPTION: A 55-year-old male with a history of myopic laser in situ keratomileusis (LASIK) presented with a volatile intraocular pressure (IOP) and blurred vision over the last seven years. He was particularly symptomatic following sexual excitation. Examination revealed an IOP of 36 mm Hg and best-corrected vision of 20/80 OD, with bilateral closed angles and a double hump sign on gonioscopy. There were advanced glaucomatous changes OD and mild-to-moderate changes OS on optical coherence tomography. Following an exploration of potential options, it was chosen to proceed with OD lens-based surgery, goniosynechialysis and endocyclophotoplasty. During OD recovery, the patient reported an episode of visual blurring OS secondary to sexual excitation, which was consistent with pupillary block and angle closure attack on examination. Initially managed with acetazolamide and laser peripheral iridotomy, he eventually underwent the same surgical procedure OS as for OD. Over 1-year of follow-up, he has achieved a stable IOP and excellent visual acuity bilaterally. CONCLUSION AND CLINICAL SIGNIFICANCE: This case highlights the importance of a thorough history, with the understanding that sexual excitation can precipitate angle-closure glaucoma. Gonioscopy must be performed even in the setting of myopia and a deep anterior chamber, and the double hump sign must be assessed. Appropriate education surrounding the risks of sexual activity in angle closure suspects is advised. HOW TO CITE THIS ARTICLE: Popovic M, Schlenker MB. Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report. J Curr Glaucoma Pract 2018;12(3):142-144. Jaypee Brothers Medical Publishers 2018 /pmc/articles/PMC6647822/ /pubmed/31354207 http://dx.doi.org/10.5005/jp-journals-10028-1259 Text en Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd. This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/
spellingShingle Case Report
Popovic, Marko
Schlenker, Matthew B
Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report
title Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report
title_full Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report
title_fullStr Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report
title_full_unstemmed Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report
title_short Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report
title_sort angle-closure glaucoma in a myopic patient precipitated by sexual excitation: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647822/
https://www.ncbi.nlm.nih.gov/pubmed/31354207
http://dx.doi.org/10.5005/jp-journals-10028-1259
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