Karen W. Jeng-Miller, MD, MPH | Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts Eric D. Gaier, MD, PhD | Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts Angela V. Turalba, MD | Department of Ophthalmology, Atrius Health, Boston, Massachusetts
On examination, his visual acuity was counting fingers in both eyes, improving with pinhole testing to 20/150 in the right eye and 20/125 in the left eye. His pupils were miotic and minimally reactive; there was no relative afferent pupillary defect. Intraocular pressure (IOP) was 54 mm Hg by Goldman applanation tonometry in each eye. Anterior segment examination revealed microcystic corneal edema and shallow anterior chambers in both eyes, with no signs of anterior chamber inflammation. There was no conjunctival injection or heterochromia of the iris. Gonioscopy demonstrated absence of angle structures in all four quadrants in each eye. Posterior segment examination of both eyes revealed normal optic nerves with cup-to-disc ratios of 0.1 and peripheral uveal effusions in all retinal quadrants. The maculae and vessels were within normal limits.