A patient has a miotic pupil, IOP = 25, normal anterior chamber, hazy cornea and a shallow anterior chamber in the fellow eye. Diagnosis is –

Here the two differential diagnosis are:- i) Acute anterior uveitis, ii) Acute angle closure glaucoma. The information in this question are :- Meiotic pupil Normal anterior chamber (with the shallow anterior chamber in the fellow eye) Mildly elevated IOT : 25 mmHg (normal 10 - 21 mm Hg) Hazy cornea Now we will discuss each of these :- Amongst the given options meiotic pupil is seen only in acute anterior uveitis. Normal anterior chamber with shallow anterior chamber in fellow eye may have any of the following : The patient is predisposed to angle-closure glaucoma due to congenital bilateral shallow anterior chamber and this shallow anterior chamber is the normal depth of anterior chamber so, a normal appearing anterior chamber in the diseased eye is in fact deep due to any disease process. or Diseased eye has normal depth of anterior chamber. While the fellow eye has shallow anterior chamber and is predisposed to angle closure glaucoma. So, the diseased eye has either normal depth or is deep (any of these can be seen in acute anterior uveitis). Mildly elevated intraocular tension may be seen in acute anterior uveitis due to obstruction of the flow of aqueous from clogging of trabecular meshwork of anterior chamber. In an attack of acute angle closure glaucoma, IOP is usually markedly raised. The hazy cornea may be seen both in angle closure glaucoma and acute anterior uveitis. So, the most probable diagnosis is acute anterior uveitis.