Dados do Trabalho

Título

AN UNUSUAL CASE OF SECONDARY GLAUCOMA?

Introdução

This case report seeks to demonstrate the association between breakdancing and glaucoma in a
previously healthy male patient.

Métodos

This is a descriptive and non-interventional observational study, in which data collection will
take place through routine consultations with the patient, analysis of previous information collected in
medical records and recording of exams and images duly authorized by the patient through the Terms of
Reference free and informed consent.

Resultados

Male patient, 51 years old, mixed race, previously healthy, breakdance
professional, with no history of ocular trauma, family members with
glaucoma or corticosteroid use (oral or topical), referred from another
service with a primary diagnosis of normal pressure glaucoma (NPG).
Visual acuity without correction was 20/60 and with correction 20/25
in both eyes and read J1 with ADD: +2.50.
Biomicroscopy was unremarkable. Fundoscopy: large optic nerve,
stained optic disc with 0.9 cup in both eyes. Eye pressure using
Goldmann tonometry: 13 mmHg. Gonioscopy: open angle.
Additional exam: computerized perimetry 24:02 consistent with
diffuse scotoma in both eyes (AO) and 10:02 with temporal island of
vision in AO; Optical coherence tomography (OCT) of optic nerve
associated with ganglion cell layer (GCL) and retinal nerve fiber layer
(CNFR) atrophy in all quadrants of both eyes.
In view of the above, the underlying cause for the development of the
disease was the patient's profession, as in a certain maneuver, head
spinning, which is performed numerous times during presentations,
there is a significant increase in intraocular pressure, confirmed with
measurement. of intraocular pressure during the handstand position,
showing an increase to 33 mmHg after 30 seconds of maneuver.
In this way, we are facing optic neuropathy without evidence of
increased intraocular pressure in the orthostatic position, however, it
suffers pressure spikes when performing the head spinning maneuver,
which possibly caused an increase in the cup/disc ratio, a decrease of
the nerve fiber layer and the visual field defect.

Conclusões

IOP greater than 24 to 30
mmHg increases the relative risk from 5.7 to 15.3 for
glaucomatous damage to the optic nerve. In the case in question,
there are no studies that demonstrate a correlation between activity
(Breakdance) and glaucoma, however, given the exclusion of
known risk factors and other causes that may cause optic
neuropathy, the main agent becomes the profession of patient.

Palavras Chave

Breakdance; head spinning; Glaucoma

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