Primary Angle Closure as a Presenting Feature of Retinitis Pigmentosa: A Rare Case Report

Primary angle closure is an acute medical emergency. There are various predisposing factors in primary angle closure glaucoma such as age > 60 years, female gender, Eastern and Indian Asian race, positive family history, hypermetropia, eyes with short axial length and thicker lens. We report a case of 50 year old female presenting with sudden painful loss of vision in right eye. After control of increased intraocular pressure slit lamp examination was done which showed bilateral phacodonesis. Indirect gonioscopy revealed grade 1 narrow angle in all quadrants in right eye and open angle in left eye. Features suggestive of retinitis pigmentosa in both eyes were found on dilated fundus examination. Laser peripheral iridotomy and cataract extraction was performed in right eye and laser peripheral iridotomy alone was done in left eye. Zonular instabilty with thick anteriorly displaced lens due to retinitis pigmentosa has been found as the main causative factor resulting in angle closure in this case.