Weightlifters - Need to Be Cautious Especially Having Pigment Dispersion Syndrome or Pigmentary Glaucoma

Abstract

Weightlifter developed sudden diminution of vision after exercise with visual acuity in right eye (RE) HM and in left eye (LE) CF 1foot, Intraocular pressure (IOP) with Goldmann applanation tonometer (GAT) in both eyes were 34 mmHg with antiglaucoma medications. Slit lamp examination of both eyes showed edematous cornea, concave configuration of iris, semi dilated pupil, sluggishly reacting to light and pigment on corneal endothelium & on clear lens in RE, LE lens was clear. Gonioscopy showed open angle with increased pigmentation. Fundus examination showed cup disc ratio 0.8 in RE & 0.85 in LE. Anterior segment optical coherence tomography (ASOCT) confirmed concave configuration of iris. Patient was treated with antiglaucoma medications & peripheral iridotomy done with Nd: YAG in BE which decreased concave configuration of iris. Visual acuity improved to 6/6 in RE & 6/9 in LE. BE IOP with GAT 14 mmHg, Humphery visual field (HVF) 10-2 showed advanced field defects, Central corneal thickness 598µ, OCT showed retinal nerve fibre layer thickness in RE 75µ & 64µ in LE. Planned for trabeculectomy with MMC subsequently in BE. Conclusion: Weightlifters can need to remain cautious especially having Pigment dispersion syndrome or pigmentary glaucoma & should undergo regular ophthalmic checkup