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Good Hope Hospital Eye Clinic
 

Glaucoma Case 10           David Kinshuck


Patient

  • age 76, female, 8y chronic open angle glaucoma
  • despite good pressure control left visual field has continued to deteriorate
  • this is unusual...good control usually prevents deterioratioin. The cause of the increasing visaul field loss has not been found.
  • on presentation there was full visual field left eye, now 8 years later, the left field is worse
  • pressures were controlled 1--16,a little higher than ideal
  • ideal pressure for this patient with deteriorating field =<11
  • Patient is using the maximum drops safe ...xalatan night and azopt three times/day
  • Patient has not been well enough for trabeculectomy. At this stage there is a choice...accept continuing deerioration or trabeculectomy with mitomycin aiming for a pressure of 10

 

cupped  disc, progressive glaucoma left eye 9despite normal pressure)

right disc shows possbile cupping
left disc is obviously cupped, see below

 

left visual field has progressed over 8 years

on presentation there was full visual field left eye, now 8 years later, the left field is worse

 

The arrow points to the notch of the disc.
A notch of the lower disc = field defect in superior field.
the arrow points to the notch

home   Case 1: PED/CNV      Case 2: hard drusen       Case 3: CSR     Case 4 CNV      Case 5 Occult      Case 6 soft drusen     Case Pre-macula haem     Case Bests    Case 10  PDT  Case 11 rip    Case 12 CNV   Case 13 CSR & PED    Case 14 Dry/Occult     Case 15 polypoidal    Case 16 myopic early CNV      Case 17 macula hole    case 18 more fluid with oct       case 19 fluid reaccumulates      Case 20 peds & nsd      Case 21 AOFVD  Case 22 AOFVD/ERM    Case 23 speckles    case24 VMT      case 25 epiretinal membrane

 

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