Pseudophakic glaucoma and angle closure in a patient with an anterior chamber intraocular lens

PURPOSE: To report use of ultrasound biomicroscopy (UBM) and anterior segment ocular coherence tomography (AS-OCT) in a case of pseudophakic glaucoma in a patient with an anterior chamber intraocular lens. OBSERVATIONS: UBM and AS-OCT were critical in determining a non-drug related etiology of angle closure. Images indicated anterior obstruction of the pupil secondary to anterior chamber intraocular lens, but also posterior obstruction of the pupil secondary to the anterior hyaloid face. CONCLUSIONS: When evaluating a patient with suspected angle closure, it is important to perform a full ophthalmologic examination, including gonioscopy, as well as a thorough review of past medical history and medications so as not to miss systemic-related etiologies. Imaging with B-scan, UBM, and, more recently in the last decade, AS-OCT is a key component of evaluation of a patient in angle closure, especially one with a complex medical and ocular history.