Unilateral Absolute Open-Angle Glaucoma with Ocular Surface Disease in Juvenile Systemic Lupus Erythematosus: ACase Report

Doi: 10.36351/pjo.v42i3.2347

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune condition with many heterogeneous ocular manifestations while glaucoma is a rare sight-threatening disease, particularly in juvenile cases. We presenta case involving a 15-year-old girl with juvenile-onset SLE and vasculitis, developed unilateral absolute open-angle glaucoma with recurrent ocular surface disease. The patient presented with no light perception in the left eye, and severely elevated intraocular pressure (IOP) despite maximum medical therapy with her right eye unaffected. Anterior segment and retinal imaging demonstrated advanced open-angle glaucoma. The affected eye developed bullous keratopathy, recurrent hyphema, hemosiderosis, blepharitis, keratitis, and band keratopathy. Cyclocryotherapy was planned but deferred after the affected eye became painless. This is an unusual presentation of unilateral absolute glaucoma secondary to juvenile SLE, likely due to inflammatory and steroid-related effects, highlighting the need for multidisciplinary care to assist detection to avoid irreversible vision loss.