Tight orbit syndrome: a previously unrecognized cause of open‐angle glaucoma

Abstract

ABSTRACT.Purpose: To describe a new syndrome of tight orbit and intractable glaucoma with a poor visual prognosis. Methods: A retrospective observational case series of six patients seen at two centres between 2001 and 2007 assessing intraocular pressure (IOP), best-corrected visual acuity and visual field. Results: Three men and three women, ranging in age at diagnosis from 14 to 53 years, demonstrated similar orbital features and progressive visual field loss despite intensive management with medication and laser and operative surgery. Highest IOPs ranged from 30 to 50 mmHg. Trabeculectomy and ⁄ or glaucoma drainage devices were attempted in five patients but all failed. One patient underwent orbital decompression with achievement of IOP control. Final IOP at last follow-up was variable; only two patients achieved IOP in the normal range, with the rest ranging from 25 to 40 mmHg. All patients had advanced visual field loss. Conclusion: Tight orbit syndrome presents a serious clinical challenge. Despite maximum medical therapy and surgical intervention IOP is difficult to control, resulting in progressive visual field loss.

Posterior Scleral Biomechanics and the Translaminar Pressure Difference

“…57,58 This is likely an extreme example of the precarious relationship of ocular and orbital pressure. 57,58 This is likely an extreme example of the precarious relationship of ocular and orbital pressure.…”

Tight orbit syndrome resulting from large globe with high myopia: intractable glaucoma treated by orbital decompression

“…Large globe due to high myopia could cause restriction of the orbital volume by the limitation of the bony orbit relative to the orbital contents. Recently, Lee et al 1 . reported six cases with various causes of globe tightness and termed them as ‘tight orbit syndrome.’ They characterized by the eyelids pressing firmly against the globe, limiting globe exposure during examination, and high‐pressure glaucoma that is extremely difficult to manage.…”

“…IOP was uncontrolled with maximal medical treatments and intractable glaucoma developed. Tight orbit syndrome has been reported to be an unrecognized cause of open‐angle glaucoma 1 …”

Reply on Lee et al., Tight orbit syndrome: a previously unrecognized cause of open‐angle glaucoma

“…We read with interest the article ‘Tight orbit syndrome: a previously unrecognized cause of open‐angle glaucoma,’ by Lee et al. (2010).…”