Formulation And Evaluation of Herbal Ointment Containing Neem and Turmeric

Cogan-Reese Syndrome is a rare and progressive ocular disorder classified under iridocorneal endothelial (ICE) syndromes, primarily affecting middle-aged females. It is characterized by abnormal corneal endothelial proliferation leading to distinct iris changes and secondary glaucoma. This case report details the clinical presentation, diagnostic approach, and management of a 42-year-old female diagnosed with CRS and secondary angle-closure glaucoma. The patient presented with progressive diminution of vision in her right eye over two months, with a history of prior glaucoma diagnosis and medical management. Ophthalmic evaluation revealed elevated intraocular pressure (IOP) in the right eye (26 mmHg) with characteristic Cogan-Reese Syndrome features, including iris nodules, ectropion uvea, peripheral anterior synechiae, and full optic disc cupping. Imaging and diagnostic tests, including optical coherence tomography, Humphrey Visual Field analysis, and pachymetry, confirmed glaucomatous changes and corneal endothelial dysfunction. Systemic laboratory investigations indicated elevated inflammatory markers, necessitating multidisciplinary assessment. Management focused on IOP control through a comprehensive medical regimen, including Brimonidine + Timolol, Brinzolamide, Travoprost, Ripasudil, and Pilocarpine eye drops, along with systemic Acetazolamide for additional pressure reduction. Neuroprotective therapy and lubricants were also prescribed. The patient was advised on regular IOP monitoring, with surgical intervention (trabeculectomy) as a potential next step if medical therapy proved insufficient. Given the systemic inflammatory markers, a rheumatology referral was recommended for further systemic evaluation. Cogan-Reese Syndrome remains a challenging condition due to its progressive nature and the potential for severe visual impairment. The case underscores the importance of early detection, detailed clinical evaluation, and individualized treatment strategies to mitigate disease progression. As Cogan-Reese Syndrome -related glaucoma often necessitates surgical intervention, long-term monitoring and multidisciplinary collaboration are crucial in optimizing patient outcomes and preserving visual function.