DR. SADANANDA S. SHETTY

DR. SHILPA DAS, DR.PRASHANTH RANGANATH

Abstract

A 20-year old female with vernal keratoconjunctivitis, was on treatment with intermittent pulsed regimen of topical steroids. On presentation, her BCVA was 6/6, IOP by Goldmann applanation tonometry was 38 and 36 mmHg in right and left eye respectively. Gonioscopy showed open angles in both eyes and fundus examination revealed VCDR of 0.7 and 0.8 with inferior rim thinning in right and left eye respectively. There were corresponding visual field defects and RNFL changes on OCT. As IOP continued to be high despite maximal medical therapy, bilateral trabeculectomy with topical Mitomycin-C was performed, left eye followed by right eye. Post-operatively IOP reduced to 14 mm Hg in both eyes, fundus examination revealed reversal of cupping in both eyes, with a VCDR of 0.3 and 0.5 in right and left eye respectively. To conclude, although rare, timely trabeculectomy can reverse glaucomatous cupping in an adult.