Drug-induced angle-closure glaucoma is an important entity for the ophthalmologist as well as the general physician as it represents a preventable cause of potential blindness. This brief review highlights the fact that a high index of suspicion, in a susceptible individual followed by confirmation on appropriate imaging modality (UBM, ultrasound or anterior segment OCT) can alleviate the threat to sight and also help to institute appropriate therapy.

To evaluate the effect of intraocular pressure (IOP) on central corneal thickness (CCT), horizontal corneal diameter (HCD), axial length (AL) in patients with primary congenital glaucoma (PCG) after antiglaucoma surgery. In this hospital based interventional study 36 patients (66 eyes) of PCG who underwent antiglaucoma surgery were included in the study. For each patient visual acuity, anterior and posterior segment examination, IOP, AL, CCT, HCD and refraction (in clear media) were recorded pre and post operatively (3 weeks, 3 months, 6 months). B scan ultrasonography was done to measure AL and to rule out posterior segment pathology. Surgery was performed by a glaucoma expert (by a single surgeon). Bilateral involvement was present in 83.33% with the most common symptom being photophobia and watering (30.56% each). The mean IOP, CCT, HCD, VCD and AL before surgery were 26.88+/-2.78 mmHg, 614.38+/-89.41 µ, 14.41+/-1.26mm, 13.19+/-1.46mm and 24.78+/-2.21mm and at 6 months were 13.85+/-1.93 mmHg, 548.56+/-63.13 µ, 14.62+/-0.49 mm, 13.34+/-1.10 mm and 25.73+/-1.36mm respectively. 59.1% of the patients had corneal clearing at 6 months. Control of IOP affects various parameters of eye like CCT, HCD and AL. Early surgery is the definitive line of management for controlling IOP in PCG patients.

Background: Following posterior capsular rupture (PCR) and vitreous loss during cataract surgery, sometimes there is inadequate support for implanting a conventional intra-ocular lens (IOL) in the capsular bag. Flexible openloop anterior chamber intraocular lens, trans-sclerally sutured posterior chamber intraocular lens and iris-claw lenses are the most acceptable alternatives in such a scenario. Objective: To review our experience with primary anterior chamber intraocular lens implantation at a District Hospital in Rajkot. Methods: Analysis of medical records of a consecutive series of primary anterior chamber intraocular lens implantations carried out at the G.T. Sheth Eye Hospital at Rajkot, from September 2011 to April 2013. Eyes with complicated or traumatic cataracts, ocular co-morbidity and cases of combined surgery were excluded from the analysis of visual outcome. Results: There were 70 cases of primary anterior chamber intraocular lens implantations during the study period. Posterior capsule rupture and resultant inadequate capsular support was the commonest indication for implanting the anterior chamber intraocular lens. Postoperatively 82.85% had a best corrected visual acuity of 6/12 or better. The commonest postoperative complications were cystoid macular oedema, recurrent iritis and persistent elevated intra-ocular pressure (IOP). Conclusion: Our results indicate a satisfactory visual outcome with primary implantation of anterior chamber intraocular lenses. Caution should be exercised when implanting an anterior chamber intraocular lens following complicated cataract surgery, particularly in the absence of appropriate capsular support.

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