University of Iowa Health Care

Ophthalmology and Visual Sciences

Iowa Glaucoma Curriculum

Supplementary Material


Chapter 23

Case from
Grant syndrome (Syndrome of precipitates on the trabecular meshwork): 60-year-old male referred for evaluation of elevated intraocular pressure (IOP), right eye with corneal edema. Treated with a laser peripheral iridotomy and started on bimatoprost and brimonidine/timolol. The only pertinent exam findings were pigmented precipitates on the anterior trabecular meshwork OD on gonioscopy.


Uveitis cases from
Chronic Uveitis w/ Cholesterol Crystals: 49 year-old woman with twenty-year history of granulomatous uveitis OD. Full work-up negative for an underlying etiology. She developed diffuse crystals in anterior chamber and angle. This was presumed to be due to her elevated serum cholesterol (366) and triglyceride (450) in the face of a compromised blood-aqueous barrier.

Fuchs-like Uveitis: 61 year-old woman who noted floaters and decreased vision in her left eye for five months. Her IOP was 37 mmHg. She presented with KP and angle neovascularization suggestive of Fuchs heterochromic iridocyclitis but, on dilated examination had severe sarcoid disease in her fundus. NOTE: This clip is presented both under uveitis and under Fuchs' heterochromic iridocyclitis.

Inflammatory PAS: Progressive peripheral anterior synechiae in a patient with chronic inflammation.
Courtesy of Howard Cohn, MD, American Hospital of Paris

Uveitis Keratic Precipitates (slit lamp only): This 30 year-old man was seen three days after new onset of anterior uveitis. He was begun on prednisolone every two hours and anti-viral therapy. After three days he developed fascinating precipitates with clear centers. He was determined to have herpes simplex virus.
Interstitial keratitis cases from gonioscopy.org

Interstitial Keratitis (slit lamp only): This 69 year old patient has had left esotropia and amblyopia since birth. She has hand motion vision in the left eye. Both eyes have ghost vessels and stromal haze.

Interstitial Keratitis w/ Descemet's Crolls (slit lamp only): This is a patient with long standing interstitial keratitis. Unfortunately the patient is deceased and the chart is not available. She was seen with these rather spectacular scrolls of Descemet’s in the posterior cornea and in the anterior chamber. This finding has been described previously (Scattergood KD, Green WR, and Hirst LW Ophthalmology 90:1518-1523, 1983). In their paper, histopathologic studies of this material demonstrated it to have the appearance of laminated scrolls of Descemet’s membrane-like tissue.