Glaucoma

Hypotony Due to Cyclodialysis Clef A patient with a history of high myopia presented as a referral from an the retina service for low intraocular pressure and blurry vision five months after pars plana vitrectomy for vitreous opacities in the left eye. His intraocular pressure was 8 on difluprednat…

Corneal Decompensation A patient with past ocular history of primary open-angle glaucoma, status post glaucoma drainage implant in the right eye, underwent cataract surgery in the right eye. Preoperative potential acuity meter testing predicted visual acuity outcome of 20/25. The patient developed …

Brimonidine Associated Uveitis A patient with a past ocular history of advanced normal tension glaucoma in both eyes presented with 1 month of blurry vision in both eyes. His exam was notable for decreased visual acuity of 20/30 in the right eye and 20/50 in the left eye. Intraocular pressure was 9…

Bilateral Tube Exposure A patient presented to the BPEI emergency room with blurry vision and pain of both eyes for 1 week. The patient had a history of Xen gel stents with injection of 0.1ml 0.04mg/mL mitomycin-C, as well as revision of both blebs with injection of triamcinolone and mitomycin-C, i…

Bleb Leak An elderly patient presented to the glaucoma department for follow up examination of her primary open angle glaucoma. Her IOP was above goal and progression was noted on Humphrey visual fields of both eyes. She underwent uncomplicated cataract extraction with intraocular lens implant comb…

Cyclodialysis Cleft A patient with no significant PMHx presented to BPEI one day after being hit with a giant rubber band in his left eye. Visual acuity of the left eye was hand motion and IOP was 21 mmHg. Examination revealed a hyphema, vitreous hemorrhage, and shallow choroidal detachments. The p…

This patient presented with low eye pressure post trauma. OCT shows hypotony maculopathy with choroidal folds. Surgery with direct suture pexy was performed. The pressure improved and the maculopathy improved.

Elevated Episcleral Venous Pressure A 59-year-old male presented with blurred vision in both eyes. He was referred to the glaucoma service for evaluation of elevated intraocular pressure. On examination, the patient was observed to have blood in Schlemm’s canal and bilateral intraretinal and subr…

Exposed Glaucoma Drainage Device A patient with a history of moderate primary open angle glaucoma, pseudophakia, and diabetic macular edema of the right eye presented for a regularly scheduled glaucoma follow-up examination. He had previously undergone a trabeculectomy and subsequent revision in th…

In this module, we will look at:




Glaucoma Pathology


Glaucoma Treatment

Glaucoma Associated with Sturge Weber A 4-week-old male was brought in by his mother for evaluation of elevated pressures in the left eye. Exam was revealing for a port wine birth mark in the V1 and V2 distribution on the left. Patient demonstrated an IOP of 32 in the left eye, with marked corneal …

Slit lamp photos demonstrating exposure of a glaucoma drainage device tube in the inferonasal quadrant without evidence of infection.

Intraoperative Aqueous Misdirection A 3-year-old boy with primary congenital glaucoma OU s/p BVT (x1 OD, x2 OS) presents to clinic with elevated IOP OD despite maximum medical therapy. He undergoes exam under anesthesia with median intraocular pressure (IOP) 37 mm Hg OD. The patient then underwent …

This patient was referred for possible iris malignancy. Ultrasound confirmed no mass. There is atrophy of the iris nasally with some variable pigmentation.

These are caused by failure of the embryonic fissure to close during the second month of development in utero. The iris defect is also known as a "keyhole" pupil. Here, there is not only an iris defect, but also missing tissue in the lens (yellow arrow) and zonules. This can cause difficulties duri…