Angle-closure glaucoma as an initial presentation of systemic lupus erythematosus.

PURPOSE: To study a patient with bilateral uveal effusions and secondary glaucoma as an initial manifestation of systemic lupus erythematosus.

DESIGN: A case report.

METHODS: The patient presented with bilateral uveal effusions and angle-closure glaucoma. A detailed ocular examination with ultrasonography and a comprehensive medical evaluation with laboratory testing were performed.

RESULTS: The ocular examination revealed bilateral uveal effusions with angle-closure and elevated intraocular pressures. A systemic evaluation revealed bilateral pleural effusions and laboratory values consistent with systemic lupus erythematosus. After medical and laser therapy failed to lower the intraocular pressure, partial thickness sclerectomies, linear sclerostomies, and choroidal drainage were successful in controlling the glaucoma.

CONCLUSIONS: Uveal effusion with secondary glaucoma can be a presenting sign for systemic lupus erythematosus. If antecedent ocular abnormalities are not present, a systemic evaluation is warranted in assessing a patient with uveal effusions and secondary angle-closure glaucoma. Partial-thickness sclerectomies, linear sclerostomies, and choroidal drainage may be effective in lowering intraocular pressure.