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¹M.D. Pendik State Hospital, Eye Clinic, Istanbul/TURKEY
²M.D. Umraniye Training and Research Hospital Eye Clinic, Istanbul/TURKEY
³M.D. Dr Lutfi Kirdar Kartal Training and Research Hospital Eye Clinic, Istanbul/TURKEY
⁴M.D. Professor, Umraniye Training and Research Hospital Eye Clinic, Istanbul/TURKEY A 59-year-old diabetic male patient was admitted to our clinic with ocular pain and lacrimation in his right eye during a hemodialysis (HD) session. In the patient history he was treated for toxic anterior segment syndrome (TASS) occurring after phacoemulsification+intraocular lens implantation+pars plana vitrectomy (PHACO+IOL+PPV with no intraocular tamponades) for vitreous hemorrhage and epiretinal membranes. The diagnosis was acute angle closure glaucoma with pupil block. After receiving intravenous 20% mannitol and topical treatment, two peripheral laser iridotomies (LI) were performed on the right eye superiorly. In later weeks, it was seen that the LI sites were occluded and intraocular pressure (IOP) increases were seen. Surgical peripheral iridectomy was performed and the IOP stabilized. We thought that as a result of severe inflammation and destruction in the trabecular meshwork, the potential cause of the IOP elevation was fluid alteration in the vitreous cavity during a HD session and inadequate trabecular outflow response to this fluid excess. Secondary to inadequate outflow this fluid excess pushes the iris lens diaphragm anteriorly and this causes angle closure glaucoma with pupil block. Thus clinicians should be aware of this IOP elevation mechanism and surgical peripheral iridectomy can solve this IOP elevation mechanism. Keywords : Angle closure, pressure, hemodialysis, toxic