Secondary open-angle glaucoma and systemic manifestations in a patient with unrepaired tetralogy of Fallot

Habiba Sultana; Khairul Islam; M. Najmul  Hoque; M. Sajidul Huq; M. Rezwanul Hasan; Nusrat Islam

doi:10.18203/2320-6012.ijrms20263554

Authors

Habiba Sultana Glaucoma Department, Deep Eye Care Foundation, Rangpur, Bangladesh https://orcid.org/0009-0000-8111-5763
Khairul Islam Glaucoma Department, Deep Eye Care Foundation, Rangpur, Bangladesh
M. Najmul Hoque Glaucoma Department, Deep Eye Care Foundation, Rangpur, Bangladesh
M. Sajidul Huq Glaucoma Department, Deep Eye Care Foundation, Rangpur, Bangladesh https://orcid.org/0000-0001-6780-8002
M. Rezwanul Hasan Glaucoma Department, Deep Eye Care Foundation, Rangpur, Bangladesh
Nusrat Islam Glaucoma Department, Deep Eye Care Foundation, Rangpur, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263554

Keywords:

Tetralogy of fallot, Secondary open-angle glaucoma, Cyanotic congenital heart disease, Ocular complications

Abstract

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. We report a rare case of secondary open-angle glaucoma in a 20-year-old male with longstanding, uncorrected TOF. The patient presented with 6 months of progressive bilateral vision loss. Ocular examination revealed prominent conjunctival vessel engorgement, elevated intraocular pressure, advanced glaucomatous optic neuropathy with increased cup-to-disc ratios, and significant retinal nerve fiber layer thinning. Notable systemic features included severe digital clubbing, skeletal deformities, congenital ear anomalies with hearing loss, short stature and hypogonadism. Prompt initiation of anti-glaucoma therapy successfully normalized intraocular pressure. This case underscores the importance of routine ophthalmic screening in patients with cyanotic congenital heart disease to detect and manage vision-threatening complications early.

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