Corneal endotheliitis in an eye with primary open-angle glaucoma

A 70 year old male was reffered to us for acute elevation of intraocular pressure (IOP) in his right eye. He had been under topical medical treatment for primary open angle glaucoma since 12 years before. The right eye showed sector-shaped corneal edema with mutton fat precipitates, leading to the diagnosis of corneal endotheliitis with iritis. Systemic and aqueous humor studies were negative for virus infection including herpes simplex. Systemic and topical corticosteroid with intensified antiglaucomatous medication induced disappearance of corneal lesions with well controlled IOP. Another episode of acute elevation of IOP while under systemic acyclovir was successfully treated by systemic and topical corticosteroids. The case illustrates that secondary glaucoma due to corneal endotheliitis and iritis is a possibility in primary open angle glaucoma.