Acute angle-closure glaucoma in a child associated with retinopathy of prematurity and general anesthesia

Purpose: To report acute angle-closure glaucoma following general anesthesia in a child with history of retinopathy of prematurity. Case: A 6-year-old girl was referred to us for conjunctival injection in her left eye that persisted since day 2 of surgery for dislocated hip joint under general anesthesia 16 days before. She had had cerebral palsy and epileptic attacks since being born premature with gestation of 26 weeks and birthweight of 868 g. Findings and Clinical Course: Intraocular pressure (IOP) was 20 mmHg right and 50 mmHg left. The left eye showed ciliary injection, corneal stromal edema and moderately dilated pupil. Ultrasound biomicroscopy showed shallow anterior chamber and thickening of the lens in both eyes. The findings led to the diagnosis of acute angle-closure glaucoma in the left eye and narrow chamber angle in the right. Both eyes received peripheral iridectomy followed by normalization of IOP. Conclusion: This case illustrates that acute angle-closure glaucoma may develop following general anesthesia in a child with history of retinopathy of prematurity, due probably to thickening of the lens and shallow anterior chamber. Peripheral iridectomy may be effective for such an attack of glaucoma.