Treatment of Uveitic Glaucoma and the Use of Ahmed Valve

Patient: A 9-year-old Hispanic female. Cause for referral 3/2000: management of uncontrolled glaucoma Chief complain: pain, redness (OU), decreased visual acuity OD>OS and severe headaches Past ocular history: a five-year history of bilateral panuveitis. She was treated with topical steroids only, without improvement of the ocular inflammation. Two years earlier, she underwent trabeculectomy with antimetabolite in both eyes. A year prior to her presentation to us, she underwent ECCE without lens implantation in the right eye and ECCE without lens implantation and cyclophotocoagulation in her left eye. Initial Examination Visual acuity: OD=20/200, OS=20/40 Slit-lamp: bilateral band keratopathy, iridectomy, trace cells in AC and aphakia. Conjunctival blebs present at 12 o’clock. IOP: 32mmHg OD, 30mmHg OS With topical Rescula bid, Cosopt bid, Alphagan qd and Prednefrin bid OU. Ophthalmoscopy: Impressive, active chorioretinitis with no vitreous inflammation or vasculitis. Large retinal scars were present in the macula of both eyes OD>OS. The optic disc in both eyes was pale and atrophic. The cup/disc ratio was 0.9 OD and 0.8 OS (Figure 1)