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38 Y woman, High myopia (-9/-9.5) BCVA: OD 6/7.5 OS 6/6 IOP 21/20 Family history of glaucoma

38 Y woman, High myopia (-9/-9.5) BCVA: OD 6/7.5 OS 6/6 IOP 21/20 Family history of glaucoma BE- lens- clear BE- C/D 0.5, tilted discs Pachymetry: 534 microns. Seek permanent refractive correction. Prefers laser over lens extraction.

brynn-miller
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38 Y woman, High myopia (-9/-9.5) BCVA: OD 6/7.5 OS 6/6 IOP 21/20 Family history of glaucoma

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  1. 38 Y woman, High myopia (-9/-9.5) • BCVA: OD 6/7.5 OS 6/6 • IOP 21/20 • Family history of glaucoma • BE- lens- clear • BE- C/D 0.5, tilted discs • Pachymetry: 534 microns Seek permanent refractive correction

  2. Prefers laser over lens extraction. • Chose PRK in view of possible complications of LASIK in high myopia (keratoectasia, DLK, flap complications, infections)

  3. Prefers lens extraction over laser.

  4. 2 week post-op. • UCVA 6/24 • Refraction -1.0 • Haze +++ • Sterodex qid

  5. 2 week post-op. • UCVA 6/6 • Refraction -0.25 • A/C clear • Stop sterodex

  6. 1 month post-op. • Night glare, monocular diplopia • UCVA 6/12 • Refraction -1.25 • Haze +++ • IOP 24 (actually higher) • Sterodex qid

  7. 1 month post-op. • UCVA 6/6 • Refraction -0.25 • IOP 15

  8. 2 month post-op. • Night glare, monocular diplopia • UCVA 6/18 • Refraction -1.5 • Haze ++ • IOP 28 • Sterodex bid • COSOPT bid

  9. 2 month post-op. • V floaters + flashes • UCVA 6/6 • Refraction -0.25 • IOP 15 • TML myopic changes

  10. 3 month post-op. • Night glare, monocular diplopia • UCVA 6/18 • BCVA 6/9 • Refraction -1.5 • Haze ++ • IOP 20 • Pred-forte bid • COSOPT + xalatan

  11. 3 month post-op. • UCVA 6/6 • Refraction -0.25 • IOP 14

  12. 6 month post-op. • Blurred vision • UCVA 6/36 • BCVA 6/12 • PSC cataract + • IOP 20 • Stop Pred-forte • COSOPT

  13. 6 month post-op. • UCVA 6/6 • Refraction -0.25 • IOP 14

  14. 1 year post-op. • UCVA 6/60 • BCVA 6/24 • PSC cataract ++ • IOP 20 • C/D 0.7 (glaucoma consultation) • VF: nasal step • Combined procedure

  15. 1 year post-op. • UCVA 6/6 • Refraction -0.25 • IOP 14

  16. What shall I do with my left left eye?

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