Background: The relationship between intraocular pressure (IOP) changes and hemodialysis has been evaluated for\r\nseveral decades. However, no report on an IOP rise in uveitis patients during hemodialysis has been previously\r\ndocumented. This report describes the case of an uveitis patient with repetitive IOP spikes associated with severe\r\nocular pain during hemodialysis sessions, which resolved after glaucoma filtering surgery.\r\nCase presentation: A 47-year-old male with diabetes and hypertension had complained of recurrent ocular pain in\r\nthe left eye during hemodialysis sessions. A slit-lamp examination showed diffuse corneal epithelial edema with\r\nseveral white keratic precipitates and inflammatory cells (Grade 3+) in the anterior chamber of the left eye. No\r\nvisible neovascularization or synechiae were visible on the iris or angle. Topical glaucoma eye-drops and\r\nintravenous mannitol before hemodialysis did not prevent subsequent painful IOP spikes in the left eye. At the end\r\nof hemodialysis, IOP averaged ~40 mmHg. After trabeculectomy with mitomycin C in the left eye, his IOP stabilized\r\nin the low-teens (range, 10ââ?¬â??14 mmHg) and no painful IOP spikes occurred during hemodialysis over the first\r\npostoperative year.\r\nConclusion: We present a case of recurrent painful IOP spikes during hemodialysis in a patient with unilateral\r\nanterior uveitis unresponsive to conventional medical treatment prior to hemodialysis. To our knowledge, this is the\r\nfirst case report of repetitive symptomatic IOP rise during hemodialysis in an uveitic glaucoma patient. This case\r\nhighlights the importance of the awareness of the possibility that IOP may rise intolerably during hemodialysis in\r\nuveitis patients with a compromised outflow facility.
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