I was called to the ED (Emergency Department) for an 18-year-old male who was a glaucoma suspect. He stated that his vision had worsened, and he was experiencing pain. I performed a tonometry (a test to determine intraocular pressure), which showed an IOP (intraocular pressure) of 25 in the right eye. A slit lamp examination was done using a portable slit lamp, revealing cupping, yellow floaters, optic nerve thinning, and a large optic disc. I reviewed his previous OCT (Optical Coherence Tomography) results and repeated the visual fields test twice, which indicated signs of intermediate glaucoma. What are your impressions, and what recommendations do you have in this case?
Hi
good to hear from you.
I suggest to start the patient on antiglaucoma therapy
to start with brimonidine + timolol twice a day.
to achieve Target pressure according to the factors involved.
here around 12-13
also monitor 6 monthly v.fields and Oct imaging to monitor progression
later on we may try surgical options like gdds or migs ... according to response by medical therapy.
long term follow up and assessment required