Association between hypertriglyceridemia and open angle glau
A 16-year-old boy was referred to our outpatient department. His chief complaints were loss of vision and redness in the right eye associated with headaches since 5 months. Patient also gave history of gradual increase in the size of right eye since 5 months. There was no gross anomaly detected on general examination. He had undergone a whole spectrum of systemic investigations including brain MRI and everything had turned out to be negative. There was one red flag sign in the battery of investigations that had been done. His triglyceride level was 679 mg/dl, which was abnormally high for his age group and he was taking lipid lowering treatment for the same (Tablet Lipaglin OD for 3 months) advised by the physician.

His ocular examination showed best corrected visual acuity of hand movement close to face in the right eye and 6/9 in the left eye. On slit lamp examinations, right eye had diffuse conjunctival congestion, mild corneal haze, normal anterior chamber depth, relative afferent pupillary defect, and small twigs of iris neovascularization in pupillary margin in 2'o clock hours. Left eye anterior segment was within normal limits, with a clear cornea and reacting pupil. Lens was clear in both the eyes. IOPby Goldmann's Applanation tonometer was 54 mmHg in right eye and 15 mmHg in left eye. Gonioscopy revealed open angles up to scleral spur in both eyes. Fundus examination with 90D lens showed glaucomatous optic atrophy with cup to disc ratio of 0.9:1 (disc pallor) in the right eye and 0.3:1 in the left eye, with normal blood vessels and bright foveal reflex. He was using following eye drops: brimonidine and brinzolamide combination BD, timolol BD and tablet acetazolamide SR BD, which was prescribed to him 2 days ago elsewhere. We added liquid glycerol 1 oz BD.

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Source: Indian Journal of Ophthalmology