AUTHOR AND EDITOR INFORMATION

Section 1 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

INTRODUCTION

Section 2 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

Background

In 1813, Joseph Beer first reported the association of uveitis and glaucoma, describing it as arthritic iritis followed by glaucoma and blindness. In 1891, Priesley Smith proposed the first modern classification of uveitic glaucoma. Later, specific types of uveitic glaucoma were described by Fuchs in 1906 (Fuchs heterochromic uveitis) and Posner and Schlossman in 1948 (glaucomatocyclitic crisis).

Pathophysiology

The mechanisms by which uveitis leads to elevated intraocular pressure (IOP) are numerous and poorly understood. In general, iridocyclitis affects both aqueous production and resistance to aqueous outflow, with the subsequent change in IOP representing a balance between these two factors. Inflammation of the ciliary body usually leads to reduced aqueous production, and combined with increased uveoscleral outflow often seen in inflammatory states, hypotony often is a consequence.

Prostaglandins, which have been demonstrated to be present in the aqueous of eyes with uveitis, are known to cause elevated IOP without a reduction in outflow facility. Mechanisms of increased resistance to aqueous outflow with both acute and subacute forms of uveitis usually are of the open-angle type and include obstruction of the trabecular meshwork by inflammatory cells or fibrin, swelling or dysfunction of the trabecular lamellae or endothelium, and inflammatory precipitates on the meshwork. Uveitis also may be associated with secondary angle-closure glaucoma.

Alteration of the protein content of the aqueous humor may be a cause of elevated IOP in uveitis. Increased levels of protein in the aqueous are a result of increased permeability of the blood-aqueous barrier, which leads to an aqueous that more closely resembles undiluted serum. This elevated protein content may, in fact, lead to aqueous hypersecretion and IOP elevation.

The treatment of the uveitis can lead to elevated IOP. Although corticosteroids have proven effective in relieving inflammation, prolonged administration can result in elevated IOP. Corticosteroids increase IOP by decreasing aqueous outflow. Several theories have been proposed to explain this phenomenon, including accumulation of glycosaminoglycans in the trabecular meshwork, inhibition of phagocytosis by trabecular endothelial cells, and inhibition of synthesis of certain prostaglandins.

Frequency

United States

Rare

International

Rare

Mortality/Morbidity

Acute iridocyclitis usually produces symptoms; however, subacute iridocyclitis produces few or no symptoms but can have serious consequences because its complications may go undetected until advanced damage has occurred. If the inflammation is not controlled promptly, posterior synechiae and peripheral anterior synechiae (PAS) can form, leading to progressive angle closure and irreversible optic nerve damage.

Race

No known racial predilection exists.

Sex

No known sexual predilection exists.

Age

No known age predilection exists.

CLINICAL

Section 3 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

History

Symptoms with acute iridocyclitis may include blurred vision, ocular pain, brow ache, and other ocular disturbances.

• Blurred vision: It often is difficult to know if the blurred vision is due to glaucoma, uveitis, or complications associated with the uveitis.
• Ocular pain: Pain is a frequent finding in acute iridocyclitis but often is not seen with subacute or chronic iridocyclitis. Some patients with markedly elevated IOP often have severe eye pain associated with corneal edema.
• Brow ache: Ocular pain associated with elevated IOP often is referred to the brow on the affected side.
• Ocular disturbances: Other ocular disturbances (eg, photophobia, colored halos) may be associated with acute iridocyclitis and corneal edema, respectively.

Physical

• The cornea may reveal band keratopathy, epithelial dendrites, or stromal scarring from herpetic infections. Corneal epithelial edema associated with acutely elevated IOP may give rise to a steamy appearance. Keratic precipitates may be present on the endothelium and have different characteristics that signify various diagnoses.
• The hallmark of anterior uveitis is the presence of cells and flare in the anterior chamber. Cellular infiltration is due to release of chemotactic factors into the anterior chamber, and flare results from leakage of protein into the anterior chamber.
• The iris should be examined for evidence of stromal atrophy, nodules, and posterior synechiae and PAS. Inflammation can result in engorgement of the blood vessels in both the iris stroma and the angle, which can be confused with rubeosis iridis.
• The lens may have pigment on the anterior capsule, and posterior subcapsular opacification may be due to uveitis or to chronic corticosteroid therapy.
• The vitreous cavity may show the presence of cells or snowball opacities.
• The IOP may be low, normal, or high due to variations in aqueous secretion, amount of outflow obstruction, and dose of corticosteroids being used.
• Gonioscopy should be performed to detect the presence of PAS and to assess the degree of angle closure.
• The posterior segment should be examined, paying particular attention to the optic nerve to document morphologic changes consistent with glaucoma. Other possible posterior segment findings include cystoid macular edema, retinitis, perivascular sheathing, choroidal infiltrates, or retinal detachment.

Causes

Many specific uveitic entities may lead to the development of glaucoma. Some of the more common syndromes are listed below.

• Juvenile rheumatoid arthritis
• • Juvenile rheumatoid arthritis (JRA) is defined as an arthritis, with a duration of at least 3 months, that begins prior to age 16 years and is diagnosed after exclusion of other causes of arthritis.
  • Glaucoma is a common complication of chronic uveitis in patients with JRA and most frequently is caused by progressive closure of the angle by PAS.
  • Since the uveitis frequently is treated with prolonged topical corticosteroids, steroid-induced glaucoma may occur. The reported incidence of glaucoma varies from 14-22%.
• Fuchs heterochromic iridocyclitis
• • Fuchs heterochromic iridocyclitis (FHI) usually is unilateral and appears between the third and fourth decades with the insidious onset of mild, chronic anterior uveitis that usually is asymptomatic.
  • The glaucoma associated with FHI resembles primary open-angle glaucoma.
  • Gonioscopic evaluation may reveal multiple fine blood vessels, arranged either radially or concentrically in the trabecular meshwork.
  • Cataract is a constant feature of FHI, whereas glaucoma has been reported to occur in 6-47% of cases.
  • The uveitis does not need treatment with anti-inflammatory or immunosuppressive agents.
• Posner-Schlossman syndrome is characterized by a number of unusual features, including unilateral involvement, recurrent attacks of often very mild cyclitis, marked elevation of IOP, open angle, and occasional heterochromia. The condition typically affects individuals aged 20-50 years and resolves spontaneously regardless of treatment.
• Herpetic uveitis
• • Herpes simplex
    • Ocular manifestations of herpes simplex virus have been classified in accordance with the site of the corneal involvement and the presence or absence of associated uveitis, including herpetic superficial keratitis, disciform keratitis, disciform keratouveitis, and necrotic stromal keratitis. Disciform keratouveitis and necrotic stromal keratitis are associated more commonly with elevated IOP than epithelial keratitis.
    • The elevated IOP may be caused by trabeculitis, inflammatory obstruction of the trabecular meshwork, and angle closure in severe keratouveitis. The management of elevated IOP initially is directed toward controlling the viral replication and inflammation.
  • Varicella zoster
    • Ocular involvement of cutaneous varicella zoster occurs in two thirds of patients when the ophthalmic division of the trigeminal nerve is involved. Dendritic keratitis, stromal keratitis, and exposure keratitis are common.
    • IOP elevation and glaucoma are believed to be caused by decreased outflow facility due to trabecular obstruction from inflammatory debris, trabeculitis, and damage to the trabecular meshwork by recurrent inflammation. Treatment with systemic acyclovir when the cutaneous lesions are still active appears to reduce the risk of elevated IOP.

DIFFERENTIALS

Section 4 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

WORKUP

Section 5 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

Lab Studies

• Laboratory investigation should be tailored to appropriate studies based on both the history and the physical findings.
• • Serology
  • Skin tests

Imaging Studies

• Chest radiographs
• Computerized tomography
• Magnetic resonance imaging
• Gallium scanning

Procedures

• Conjunctival biopsy
• Vitreous biopsy
• Anterior chamber paracentesis

TREATMENT

Section 6 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

Medical Care

Treatment of glaucoma in uveitis depends on the underlying disease and on the individual patient. The treatment rationale consists of (1) treating any underlying systemic disease, (2) treating the ocular inflammation, and (3) treating the glaucoma. The ocular inflammation and glaucoma usually can be controlled with eye drops. Often, treatment of the inflammation will control the IOP.

Surgical Care

It is a general rule that surgery should be avoided, when possible, in the inflamed eye. However, if surgery is required, the eye should receive maximal preoperative anti-inflammatory therapy to decrease the inflammation as much as possible.

In eyes with active uveitis, preparation for intraocular surgery should include perioperative topical and, occasionally, systemic corticosteroid therapy to avoid exacerbation of uveitis and failure of filtering surgery. If an elective surgical case is to be performed, the uveitis should be as quiet as possible for 3 months prior to surgery. One week prior to surgery, topical prednisolone 1% solution should be given hourly, and oral prednisone 40 mg daily should be considered.

At the conclusion of surgery, a depot of corticosteroid should be injected subconjunctivally. Postoperatively, topical and oral corticosteroids may be tapered according to control of the inflammation. In emergency cases, severe postoperative exacerbation of existing inflammation should be anticipated; therefore, aggressive perioperative topical and systemic corticosteroid therapy is warranted.

• Laser iridotomy
• • Extensive posterior synechiae formation can lead to pupillary block glaucoma, so it is important to reestablish communication between the posterior and anterior chambers before a full-blown attack of pupillary block occurs. Performing laser iridotomy prophylactically is preferable to performing this procedure during an attack of angle-closure glaucoma because visualization of the iris may be difficult due to corneal edema caused by high IOP.
  • An argon laser or an Nd:YAG laser may be used to perform the iridotomy. In patients with uveitis, the Nd:YAG laser may have the advantage of inducing less postoperative inflammation and requiring less energy compared with the argon laser. Combined Nd:YAG laser and argon laser is preferable in eyes with thick brown irides. Also, combined laser may allow for a larger iridotomy, which may be less prone to close.
  • Transient anterior chamber inflammation occurs in all eyes after this procedure, so topical corticosteroids should be used 4 times daily for 5 days postoperatively. When laser iridotomies are unsuccessful or when the use of a laser is contraindicated, a surgical iridectomy should be performed in cases of inflammatory angle-closure glaucoma. Since this procedure can lead to increased postoperative inflammation, topical and, sometimes, systemic corticosteroids are required in the perioperative period.
• Trabeculectomy
• • Trabeculectomy surgery is indicated for eyes with closed-angle, open-angle, or combined mechanism glaucoma when IOP is believed to be too high, despite maximum tolerated medical and laser therapy. Due to an accelerated wound healing response in uveitis, the results of trabeculectomy generally are poor, particularly in young patients.
  • Antimetabolite therapy in association with trabeculectomy has been shown to improve the success rate of trabeculectomy in patients with a high risk of failure. Postoperative subconjunctival injection of 5-fluorouracil (5-FU) or, more recently, intraoperative application of mitomycin-C is used widely to supplement standard trabeculectomy. The mitomycin can be applied to the eye for a variable duration prior to or after dissection of the scleral flap. Irrigation of the subconjunctival tissues should be carried out to prevent intraocular exposure.
• Drainage implantation: Drainage implants are designed to route aqueous from the anterior chamber to a posterior reservoir. They are particularly useful in cases with significant conjunctival scarring due to previous surgery. Drainage valves, such as the Ahmed valve, may be safer than trabeculectomy, as less risk of hypotony exists, which can be seen in postoperative uveitic eyes due to decreased aqueous production.
• Cycloablation: As a last resort, cycloablative techniques can be employed. Diode or Nd:YAG laser cyclophotocoagulation can be used to destroy the secretory ciliary epithelium, leading to decreased aqueous production. Unfortunately, cycloablative procedures often exacerbate the inflammation. These methods are reserved for eyes with poor visual potential due to the relatively high risk of further vision loss and phthisis bulbi.

Consultations

• Uveitis specialist
• Rheumatologist
• Glaucoma specialist

Diet

No special diet is required.

Activity

Avoid strenuous exercise and heavy lifting in the early postoperative period.

MEDICATION

Section 7 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

Common anti-inflammatory treatment entails use of nonsteroidal anti-inflammatory drugs (eg, topical, systemic); corticosteroids (eg, topical, subconjunctival, systemic); and, rarely, immunosuppressive agents. More recently, fluocinolone acetonide intravitreal implants have been used with success to treat posterior uveitis. Mydriatic-cycloplegic agents may be used to prevent or break posterior synechiae and to relieve pain and discomfort of ciliary muscle spasm. Available agents include atropine 1%, homatropine 1-5%, scopolamine, phenylephrine 2.5-10%, and tropicamide 0.5-1%.

Many agents are available for lowering of IOP, including topical beta-blockers, adrenergic agents, and topical and systemic carbonic anhydrase inhibitors. Miotics are avoided in uveitic glaucoma because of the risk of formation of posterior synechiae or a pupillary membrane. They also may increase inflammation by enhancing breakdown of the blood-aqueous barrier. The role of prostaglandin analogs in uveitic glaucoma is unknown, but their effect on the inflammatory cascade may profoundly affect intraocular inflammation, so these agents should be used with caution.

Drug Category: Beta-blockers

Lower IOP by decreasing the production of aqueous humor.

Drug Name	Levobunolol 0.25% or 0.5% (Betagan, AKBeta)
Description	Nonselective beta-adrenergic blocking agent that lowers IOP by reducing aqueous humor production.
Adult Dose	0.5% solution: 1-2 gtt in affected eye(s) qd 0.25% solution: 1-2 gtt in affected eye(s) bid
Pediatric Dose	Not established
Contraindications	Documented hypersensitivity; bronchial asthma; severe COPD; sinus bradycardia; second- and third-degree AV block; overt cardiac failure; cardiogenic shock
Interactions	May cause bradycardia and asystole when used in combination with systemic beta-blockers (may cause additive effects)
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	Beta-blockade may potentiate muscle weakness that is consistent with certain myasthenic symptoms (eg, diplopia, ptosis, generalized weakness); product may have sulfites, which may cause allergic-type reactions in certain susceptible persons

Drug Category: Carbonic anhydrase inhibitors

Lower IOP by decreasing aqueous production. Oral and topical forms are available.

Drug Name	Methazolamide (Neptazane, GlaucTabs)
Description	Reduces aqueous humor formation by inhibiting enzyme carbonic anhydrase, which results in decreased IOP.
Adult Dose	50-100 mg PO bid/tid
Pediatric Dose	Not established
Contraindications	Documented hypersensitivity; renal impairment
Interactions	May increase toxicity of salicylate, digoxin; coadministration with other diuretics may induce hypokalemia; decreases effects of lithium and alters excretion of other drugs by alkalinizing urine
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	Caution in respiratory acidosis and diabetes mellitus; impairs mental alertness and/or physical coordination; hematuria, glycosuria, polyuria, hepatic insufficiency, bone marrow suppression, thrombocytopenia/purpura, agranulocytosis, urticaria, pruritus, and rash may occur

Drug Name	Dorzolamide 2% (Trusopt); Brinzolamide 1% (Azopt)
Description	Both act by inhibition of carbonic anhydrase in the ciliary processes that decreases aqueous humor formation.
Adult Dose	1 gtt to affected eye(s) bid/tid
Pediatric Dose	Not established
Contraindications	Documented hypersensitivity
Interactions	Possible toxicity associated with high-dose salicylate therapy
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	Caution in renal and hepatic impairment

Drug Category: Adrenergic agonists

Lower IOP by a combination of decreasing production of aqueous and increasing aqueous outflow.

Drug Name	Brimonidine (Alphagan)
Description	Selective alpha2-receptor that reduces aqueous humor formation and possibly increases uveoscleral outflow.
Adult Dose	1 gtt in affected eye(s) tid
Pediatric Dose	<2 years: Not recommended; severe mental, cardiovascular, and pulmonary depression have been reported in pediatric patients >2 years: Not established
Contraindications	Documented hypersensitivity; patients receiving MAOIs
Interactions	Coadministration with topical beta-blockers may further decrease IOP; tricyclic antidepressants may decrease effects of brimonidine; CNS depressants (eg, barbiturates, opiates, sedatives) may potentiate effects of brimonidine
Pregnancy	B - Usually safe but benefits must outweigh the risks.
Precautions	Caution in cardiovascular disease, depression, cerebral or coronary insufficiency, orthostatic hypotension, and Raynaud syndrome

Drug Category: Prostaglandin analogs

Lower IOP by increasing aqueous outflow.

Drug Name	Bimatoprost ophthalmic solution (Lumigan)
Description	A prostamide analogue with ocular hypotensive activity. Mimics the IOP-lowering activity of prostamides via the prostamide pathway. Used to reduce IOP in open-angle glaucoma or ocular hypertension.
Adult Dose	1 gtt of 0.03% solution in affected eye(s) hs; not to exceed 1 dose/d
Pediatric Dose	Not established
Contraindications	Documented hypersensitivity
Interactions	None reported
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	May cause permanent increase in pigment to iris (ie, increases brown pigment) and eyelid; may increase eyelash growth; may cause bacterial keratitis; caution in uveitis or macular edema; do not instill if wearing contact lenses

Drug Name	Travoprost ophthalmic solution (Travatan)
Description	Prostaglandin F2-alpha analog. Selective FP prostanoid receptor agonist believed to reduce IOP by increasing uveoscleral outflow. Used to treat open-angle glaucoma or ocular hypertension.
Adult Dose	1 gtt in affected eye(s) hs; not to exceed 1 dose/d
Pediatric Dose	Not established
Contraindications	Documented hypersensitivity
Interactions	None reported
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	Commonly causes ocular hyperemia; may cause permanent increase in pigment to iris (ie, increases brown pigment) and eyelid; may increase eyelash growth; may cause bacterial keratitis; caution in uveitis or macular edema; do not instill if wearing contact lenses

Drug Name	Unoprostone ophthalmic solution (Rescula)
Description	Docosanoid that reduces IOP by increasing outflow. The true mechanism of action has not been determined. Used to treat open-angle glaucoma or ocular hypertension.
Adult Dose	1 gtt in affected eye(s) bid
Pediatric Dose	Not established
Contraindications	Documented hypersensitivity
Interactions	None reported
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	Commonly causes ocular irritation; may increase eyelash growth or even decrease length of eyelashes; rarely may cause permanent increase in pigment to iris (ie, increases brown pigment) and eyelid; may cause bacterial keratitis; caution in uveitis or macular edema; do not instill if wearing contact lenses

Drug Category: Nonsteroidal anti-inflammatory agents

Have analgesic and anti-inflammatory activities. Their mechanism of action is not known but may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms also may exist, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.

Drug Name	Diclofenac sodium 0.1% (Voltaren)
Description	Believed to inhibit cyclooxygenase, which is essential in the biosynthesis of prostaglandins.
Adult Dose	1 gtt in affected eye(s) qid
Pediatric Dose	Not established
Contraindications	Documented hypersensitivity
Interactions	None reported
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	Should not be used by patients wearing soft contact lenses; use with caution in surgical patients with known bleeding tendencies; there is potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other nonsteroidal anti-inflammatory agents

Drug Category: Topical corticosteroids

Treatment of ocular inflammation.

Drug Name	Fluorometholone 0.1% (FML)
Description	Believed to act by the induction of phospholipase A-2 inhibitory proteins. Shows a lower propensity to increase IOP than dexamethasone in clinical studies.
Adult Dose	1 gtt in affected eye(s) qid; may increase dosage prn to derive clinical response
Pediatric Dose	<2 years: Not established >2 years: Administer as in adults
Contraindications	Documented hypersensitivity; most viral and fungal diseases of the anterior segment
Interactions	None reported
Pregnancy	C - Safety for use during pregnancy has not been established.
Precautions	Withdrawal of treatment should be carried out by gradually decreasing the frequency of applications

FOLLOW-UP

Section 8 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

Further Outpatient Care

• Patients should receive follow-up care as needed.

In/Out Patient Meds

• See Medication.

Complications

• Complications of uveitis include the following:
• • Band keratopathy
  • Corneal decompensation
  • Posterior subcapsular cataract
  • Vitreous opacities
  • Retinal or choroidal detachment
  • Macular edema
  • Disc edema
• Postoperative complications include the following:
• • Postoperative complications (eg, choroidal effusion, choroidal hemorrhage, shallow anterior chamber, hypotony) may be higher in eyes with uveitic glaucoma than with primary open-angle glaucoma after trabeculectomy with wound modulation.
  • Postoperative inflammation is fairly common in eyes with uveitic glaucoma, although this incidence can be lowered by treating the patients with preoperative and postoperative corticosteroids.
  • The combination of postoperative inflammation and shallow anterior chamber can lead to the formation of PAS, which may interfere with the function of the glaucoma filter. Cataract formation also is very common with this scenario; therefore, prolonged periods of postoperative shallowing of the anterior chamber should be avoided.
  • Phthisis bulbi may occur after any surgical procedure for uveitic glaucoma but is particularly common after cycloablative therapy. Eyes that may be at high risk of developing phthisis include those with a totally occluded angle and a relatively low preoperative IOP.

Prognosis

• Outcome and prognosis of surgery
• • Few published reports are available that address the results of surgery in patients with uveitic glaucoma.
  • Hoskins et al achieved successful lowering of IOP in 6 of 9 eyes undergoing trabeculectomy for uveitic glaucoma.
  • Hill et al showed a success rate of 81% at 12 months. The success rate of trabeculectomy with antimetabolite supplementation has been reported to be higher (71-100%).
  • Wright et al reported that 3 of 24 patients undergoing trabeculectomy with mitomycin-C required subsequent drainage implants and that 7 of 24 patients lost 2 or more lines of Snellen acuity.
  • Hill et al reported a success rate of 79% of eyes undergoing Molteno tube implantation.
  • Ceballos et al reported a success rate of 91.7% in eyes undergoing Baerveldt drainage device placement for uveitic glaucoma.
  • Ozdal et al showed a 2-year success rate of 60% in eyes undergoing Ahmed drainage device placement for uveitic glaucoma.

Patient Education

• For excellent patient education resources, visit eMedicine's Glaucoma Center and Eye and Vision Center. Also, see eMedicine's patient education articles Glaucoma Overview, Anatomy of the Eye, Glaucoma FAQs, Understanding Glaucoma Medications, and Iritis.

MISCELLANEOUS

Section 9 of 10  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

Medical/Legal Pitfalls

• Closely observe a patient on corticosteroid therapy with frequent IOP checks, because topical, local, and systemic corticosteroids can lead to elevation of IOP.

REFERENCES

Section 10 of 10

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• Miscellaneous
• References

• Ceballos EM, Parrish RK, Schiffman JC. Outcome of Baerveldt glaucoma drainage implants for the treatment of uveitic glaucoma. Ophthalmology. Dec 2002;109(12):2256-60. [Medline].
• Herndon LW. Glaucoma associated with anterior uveitis. Current Ocular Therapy. 2000;5:470-1.
• Hill RA, Heuer DK, Baerveldt G, et al. Molteno implantation for glaucoma in young patients. Ophthalmology. Jul 1991;98(7):1042-6. [Medline].
• Hill RA, Nguyen QH, Baerveldt G, et al. Trabeculectomy and Molteno implantation for glaucomas associated with uveitis. Ophthalmology. Jun 1993;100(6):903-8. [Medline].
• Hoskins DH, Hetherington J, Shaffer RN. Surgical management of the inflammatory glaucomas. Perspect Ophthalmol. 1977;1:173-81.
• Jaffe GJ, McCallum RM, Branchaud B. Long-term follow-up results of a pilot trial of a fluocinolone acetonide implant to treat posterior uveitis. Ophthalmology. Jul 2005;112(7):1192-8. [Medline].
• Kwon YH, Dreyer EB. Inflammatory glaucomas. Int Ophthalmol Clin. Winter 1996;36(1):81-9. [Medline].
• Moorthy RS, Mermoud A, Baerveldt G, et al. Glaucoma associated with uveitis. Surv Ophthalmol. Mar-Apr 1997;41(5):361-94. [Medline].
• Ozdal PC, Vianna RN, Deschenes J. Ahmed valve implantation in glaucoma secondary to chronic uveitis. Eye. Feb 2006;20(2):178-83. [Medline].
• Wright MM, McGehee RF, Pederson JE. Intraoperative mitomycin-C for glaucoma associated with ocular inflammation. Ophthalmic Surg Lasers. May 1997;28(5):370-6. [Medline].

Article Last Updated: Apr 14, 2006