Seeing Beyond the Expected: An Uncommon Case of Plateau Iris Syndrome in the Outpatient Setting

TL;DR

A 59-year-old woman with persistent high eye pressure and pain was diagnosed with plateau iris syndrome and successfully treated with laser and medication.

Contribution

This case highlights the importance of recognizing plateau iris syndrome in outpatient settings to prevent blindness.

Findings

Plateau iris syndrome was diagnosed in a patient unresponsive to standard treatments.

Argon laser iridoplasty resolved the patient's symptoms and elevated intraocular pressure.

Early diagnosis and proper management can prevent irreversible blindness in PIS.

Abstract

Patients presenting with elevated intraocular pressures (IOPs) refractory to laser peripheral iridotomy should be suspected to have plateau iris syndrome (PIS). We present an uncommonly seen case of a 59-year-old female who presented with blurred vision, left-sided head pain, and IOPs Oculus Uterque (OU). Despite medical and laser peripheral iridotomy, left eye pain and elevated IOPs persisted, which led to a suspected diagnosis of PIS. The patient was subsequently treated by a glaucoma specialist who performed argon laser iridoplasty. Following this procedure alongside appropriate pharmacologic maintenance treatment, the patient’s symptoms and elevated IOPs were resolved. With proper management, irreversible blindness can be prevented in PIS.

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