Secondary glaucoma caused by varicella-zoster virus keratouveitis: A case report and literature review

Abstract

Objective: To analyze the clinical manifestations of secondary glaucoma caused by varicella-zoster virus(VZV)keratouveitis, and to explore its treatment plan. Methods: The clinical information of a patient with secondary glaucoma caused by VZV keratouveitis was collected, and the relevant literatures were reviewed. The clinical symptoms, diagnosis, and treatment of secondary glaucoma caused by VZV keratouveitis were analyzed. Results: The female patient aged 55 years old was admitted to hospital because of“visual acuity of the left eye decreased for more than 40 d”. Physical examination showed conjunctival congestion in the left eye, diffuse corneal edema, endothelial pigment keratic precipitates(KP), aqueous humor turbidity and glow, iris depigmentation, part of iris posterior synechia, and fundus blurred. The gonioscope results showed a large amount of pigmentation in the chamber angle, and aqueous humor virus detection showed that VZV was strongly positive, which was diagnosed as secondary glaucoma caused by VZV keratouveitis. The patient was locally treated with systemic anti-inflammatory, antiviral and intraocular pressure-lowering drugs, and the intraocular pressure was decreased insignificantly. After anterior chamber irrigation, the intraocular pressure was decreased, and the condition was improved and the patient was discharged from the hospital. Conclusion: Aqueous virus testing is an effective method for diagnosing VZV keratouveitis, anterior chamber washout is a successful treatment for glaucoma caused by VZV keratouveitis with a lot of pigmentation in the corners.