GLAUCOMA WITH INFLAMMATORY PRECIPITATES ON THE TRABECULAR MESHWORK - A REPORT OF GRANTS SYNDROME WITH ULTRASOUND BIOMICROSCOPY OF PRECIPITATES

Background: The syndrome of inflammatory precipitates on the trabecula r meshwork is a rare form of inflammatory glaucoma that was described by Chandler and Grant in 1968 and subsequently given the eponym Grant' s syndrome. Methods: We present two cases of elevated intraocular pres sure associated with inflammatory precipitates on the trabecular meshw ork in otherwise relatively quiet eyes, consistent with Grant's syndro me. We review the epidemiology, clinical features: and mechanism of th is syndrome. In addition, we demonstrate the use of ultrasound biomicr oscopy for imaging angle inflammatory precipitates. Results: Our patie nts demonstrate the cardinal features of Grant's syndrome, including a cute. onset. significant elevation of tension, trabecular meshwork pre cipitates in an otherwise quiet eye, limited response to typical press ure lowering agents, excellent response to topical steroids, evidence of recurrence with bilaterality, and systemic association with sarcoid osis. Ultrasound biomicroscopy proves to be a useful adjunct for patho logic imaging. Conclusions: The syndrome of glaucoma with inflammatory precipitates on the trabecular meshwork is a rare entity that should be considered as a possible diagnosis of elevated intraocular pressure s in otherwise apparently quiet eyes.