Clinical profile of secondary glaucoma and its management in a tertiary eye care center: A hospital-based prospective study

Abstract: PURPOSE: To study the clinical profile of secondary glaucoma and its management in a tertiary eye care center. METHODS: This hospital-based, prospective study was conducted for 1 year, including patients with high intraocular pressure (IOP) >21 mmHg, a history of ocular trauma, inflammation of the eye, long-term steroid use, any associated eye or systemic disease, and a history of ocular surgery. After the proper history, detailed examination, including visual acuity, anterior segment, posterior segment examination, IOP, gonioscopy, and anterior chamber depth via A-Scan, and central corneal thickness, was done for all the patients enrolled in the study. RESULTS: The prevalence of secondary glaucoma was found to be 19.5%. The most common risk factor associated with secondary glaucoma was found to be hypermature and intumescent cataracts in 40.8% of total eyes. Phacomorphic glaucoma (38.8% eyes) was the most common cause, followed by inflammatory glaucoma (17%). The best-corrected visual acuity at presentation and posttreatment visual acuity at 6 months were recorded. At 6 months of follow-up, phacomorphic (17.5% eyes) and steroid-induced glaucoma (66.66% eyes) showed the best visual recovery with 6/36–6/18 visual acuity. The mean IOP was recorded at 2 weeks, 3 months, and 6 months of follow-up. Malignant glaucoma presented with the highest IOP at presentation, followed by phacomorphic glaucoma. Most of the eyes underwent medical treatment, followed by surgical treatment (57%). CONCLUSION: The study showed that the prevalence of secondary glaucoma was 19.5%. The most common associated risk factors were intumescent and hypermature cataracts. The most common type of secondary glaucoma encountered was phacomorphic glaucoma. Significant reduction in IOP after treatment was found in 95% of eyes with P < 0.05. Visual acuity improvement was found to be best in steroid-induced glaucoma. Medical management, followed by surgical management, was successful in controlling IOP in the majority of eyes.