Abstract: Science Set Journal of Ophthalmology and Eye Care

Abstract:
We report the case of a 30-year-old male mechanic who sustained blunt ocular trauma to his right eye from a metallic object, resulting in a complex pupillary block. Examination revealed a painful, red eye with bullous keratopathy, retro-Descemet folds, shallow anterior chamber, non-reactive mydriasis, uveal effusion, and an intumescent cataract luxated into the anterior chamber with iris pigment on the anterior lens capsule. Intraocular pressure was markedly elevated at 45 mmHg, and B-scan ultrasonography revealed total retinal detachment adherent to the lens. The patient underwent urgent surgical extraction of the luxated lens, which relieved the pupillary block and allowed partial recovery of ocular structures. Postoperative management included topical hypotensive therapy, resulting in stabilization of intraocular pressure at 16 mmHg and initial corneal clearing. This case highlights the rare combination of lens-induced and retinal mechanisms leading to secondary angle-closure glaucoma after trauma and emphasizes the need for timely surgical intervention.