University of Iowa Health Care

Ophthalmology and Visual Sciences

Iowa Glaucoma Curriculum

Supplementary Material


Chapter 28

Epithelial downgrowth case from
Epithelial Downgrowth: This patient was referred for a glaucoma evaluation. She had a history of undergoing an intracapsular cataract extraction in 1979. In November 2004 she had a secondary anterior chamber intraocular lens placed and subsequently developed intractably elevated intraocular pressure. She was seen in this video 8 months after the anterior chamber intraocular lens was placed.


Fibrous downgrowth case from

Fibrous Downgrowth: This 45-year-old woman has primary open angle glaucoma and had undergone multiple surgeries in this eye including a trabeculectomy in 2007, which required a revision and then an Ahmed stunt surgery, which also required a revision. She was hypotonus for periods during her postoperative care. She was then seen by another physician who found that her Ahmed Seton tube was impaled into her crystalline lens, which required her to have a shunt revision with a cataract extraction. She later underwent another Ahmed revision and subsequently a Baerveldt Seton with a pars plana vitrectomy and the tube placed in the posterior segment. She was referred to the University of Iowa because of the corneal changes seen in this video.


UGH syndrome cases from
UGH Syndrome: This 88 year-old woman had a cataract extraction in the right eye 21 years prior to this exam. She had an iris clip intraocular lens placed and was doing well until the day before presenting when she had sudden loss of vision in the right eye. She had an intraocular pressure of 8 mmHg with corneal guttata and Descemet’s folds. She had pigmented vitreous cells.

UGH Syndrome - slit lamp only: This patient had extracapsular cataract extraction cataract extraction with intraocular lens performed in 1995. He developed chronic iritis at a sputtering hyphema from a lens rubbing on his iris vessels. He ultimately required intraocular lens exchange.


Pseudophakic pupillary block case from

Pseudophakic Pupillary Block: After cataract surgery this patient developed chronic inflammation that was diagnosed as P.acnes endophthalmitis for which he underwent lens exchange with a limited anterior vitrectomy and intravitreal antibiotics. One week later he was found to have an elevated intraocular pressure and evidence of iris bombé with the iris ballooning around his anterior chamber intraocular lens. After laser iridotomy this entirely resolved and his pressure returned to normal.