Current Concepts of the Uveitis-Glaucoma-Hyphema (UGH) Syndrome

Curr Eye Res. 2023 Jun;48(6):529-535. doi: 10.1080/02713683.2022.2156547. Epub 2023 Jan 4.

Abstract

Purpose: To discuss the pathophysiology, etiology, and current management strategies of uveitis-glaucoma-hyphema (UGH) syndrome.

Methods: Literature review.

Results: The classic UGH syndrome associated with anterior chamber intraocular lenses (ACIOL) have decreased in incidence with the modernization of IOL design and surgical techniques. The current UGH syndrome is increasing in prevalence largely related to a parallel increase in late onset dislocations of intraocular lenses (IOLs) and the developing techniques to remedy that condition. The modern features of UGH can present as cystoid macular edema, intraocular pressure elevation typically not attributed to UGH, and recurrent vitreous hemorrhage, unlike the original description as described by Ellingson in 1978. Medical management to control inflammation, reduce intraocular pressure, and reduced the bleeding diathesis are mainstays of therapy. However, surgery with IOL repositioning or exchange should be reserved for cases that are refractory to or progressing despite medical treatment.

Conclusions: UGH syndrome is an increasingly common, poorly understood, and often subtle, manifestation of an anatomic disturbance post intraocular surgery that persists with continued evolution of intraocular surgical techniques and new imaging modalities to aid in its diagnosis.

Keywords: Uveitis-glaucoma-hyphema syndrome; cataract surgery; cystoid macular edema; secondary IOL; vitreous hemorrhage.

Publication types

  • Review

MeSH terms

  • Glaucoma* / diagnosis
  • Glaucoma* / etiology
  • Glaucoma* / surgery
  • Glaucoma, Open-Angle* / diagnosis
  • Humans
  • Hyphema / diagnosis
  • Hyphema / etiology
  • Hyphema / surgery
  • Lens Diseases* / surgery
  • Lens Implantation, Intraocular / adverse effects
  • Lenses, Intraocular* / adverse effects
  • Postoperative Complications / surgery
  • Syndrome
  • Uveitis* / diagnosis
  • Uveitis* / etiology