Topic outline

  • Grand Rounds

    A 32-year-old female presented to Bascom Palmer Eye Institute complaining of an inferior field defect in her left eye. Examination revealed 20/20 vision with correction, an APD, normal IOP, PCIOL, and optic nerve pallor and cupping of the left eye. Right eye exam was WNL. HVF 24-2 testing showed a dense inferior arcuate and inferior nasal step along with an early superior arcuate defect of the left eye. OCT NRFL and OCT GCIPL showed diffuse thinning of the left eye. The patient later revealed that she had used ophthalmic steroid ointment on her eyelid margins for treatment of blepharitis for 6 years. Six months prior to presentation, her IOP was elevated to 50 mmHg in the left eye and a PSC cataract was noted to be limiting her vision in the left eye. She underwent cataract extraction with IOL implant and Kahook Dual Blade in the left eye at an outside institution. The diagnosis of steroid-induced glaucoma was made. Her IOP was controlled on oral acetazolamide and topical tafluprost at the time of presentation. The patient wished to get pregnant in the near future and therefore plans were made to discontinue both glaucoma medications as they are not recommended in pregnancy.

    Presentation Date: 10/08/2020
    Issue Date: 02/12/2021