A pseudophakic patient presents with recurrent episodes of transient blurred vision, microhyphema, and elevated intraocular pressure. Gonioscopy and ultrasound biomicroscopy suggest intermittent contact between the optic edge of a single-piece acrylic posterior chamber lens and the posterior surface of the iris. The mechanism of this condition is:

• A Chronic trabecular meshwork obstruction by inflammatory debris alone
• B Steroid-induced elevation of intraocular pressure from postoperative drops
• C Mechanical chafing of the iris and ciliary body by the intraocular lens, causing recurrent bleeding and pressure rise ✓
• D Neovascularization of the angle secondary to retinal ischemia

Explanation

Uveitis-glaucoma-hyphema (UGH) syndrome results from mechanical irritation of the iris and ciliary body by a malpositioned or mobile intraocular lens, classically an anterior chamber or sulcus-fixated lens whose haptics or edge rub the uveal tissue. Repeated microtrauma causes microhyphemas, chronic low-grade inflammation, trabeculitis, and pressure spikes. Neovascular glaucoma would show rubeosis and widespread retinal ischemia, and steroid responders lack hyphema and show diffuse open-angle pressure rise rather than episodic bleeding.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

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Written and medically reviewed by the StethoPrep medical team.