Iridocorneal Endothelial (ICE) Syndrome : A Case Report

ABSTRACT: This is a case of a 50 year old female who presented with blurring of vision on the left eye. This was accompanied by on and off eye pain, and foreign body sensation. Previous consults were done wherein the patient was given topical ophthalmic lubricants. However, due to the progression of the blurring of vision, patient sought consult at our institution. Ophthalmologic examination revealed a visual acuity of 20/20 on the right eye and counting fingers at 3ft on the left eye, cornea was hazy and iris abnormalities seen on the left eye. Intraocular pressure at initial consult was within normal on the right eye and elevated on the left eye. Patient was then referred to External Disease & Cornea as well as Glaucoma service for further evaluation and management. A clinical impression of Iridocorneal Endothelial Syndrome and secondary glaucoma was made. She was managed medically with pressure lowering agents and hypertonic saline solution. A month from initial consult, visual acuity improved and decrease in corneal edema was noted. However, the patient was unable to return for subsequent follow-up and came back complaining of eye pain and progressive blurring of vision. Surgical management was then planned to control the intraocular pressure and reduce corneal edema. The patient eventually underwent a glaucoma filtering surgery (trabeculectomy) which successfully controlled and maintained intraocular pressure within normal levels. After controlling the IOP, Corneal transplantation (penetrating keratoplasty) pupilloplasty and cataract extraction was then done 6 months post-trabeculectomy. Currently, visual acuity on the left eye was 5/200 improved to 20/63 on pinhole and maintained IOP within normal levels without the aid of IOP-lowering medications.

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