Isolated Optic Disc Drusen as a Cause of Pseudopapilledema in a Nanophthalmic Eye with Angle-Closure Glaucoma

Abstract

Nanophthalmos is a rare ocular condition characterized by small, hyperopic eyes with short axial length, thickened sclera, and narrow anterior chamber, predisposing patients to angle-closure glaucoma and surgical complications. We report a 45-year-old female presenting with angle closure glaucoma and intraocular pressure (IOP) was 27 mmHg in the right eye and 46 mmHg in the left eye. Examination revealed shallow anterior chambers, iris bombe, ectropion uveae, crowded optic discs. Biometric measurements confirmed axial lengths under 18 mm and shallow anterior chamber depths. B-scan ultrasonography identified optic disc drusen as the cause of pseudopapilledema. Management included topical antiglaucoma medications in the right eye and peripheral laser iridotomy with medical therapy in the left eye. This case underscores the importance of biometric evaluation in hyperopic patients with angle-closure glaucoma and highlights that pseudopapilledema may result from isolated optic disc drusen in addition to high hyperopia or a small globe.