Clinical Practice Today Quick Case: Treating Glaucoma in a Patient With Nanophthalmos

Tuesday, July 18, 2017
By Catherine Lewis | Duke Health

A 63-year-old woman with nanophthalmos consulted her local ophthalmologist when she began experiencing eye pain and blurred vision. The ophthalmologist diagnosed her with angle-closure glaucoma and performed laser iridotomy to attempt to reduce her intraocular pressure (IOP) and preserve her vision.

However, because of her shortened axial length—17.6 mm in her right eye and 17.48 mm in her left—the procedure was unsuccessful; her IOP spiked, and her vision began to rapidly deteriorate.

The ophthalmologist prescribed several glaucoma medications, but her IOP remained high, so he referred her to the Duke Eye Center. At Duke, she was also diagnosed with cataracts that would require surgery.

Question: In what ways does nanophthalmos make surgery more difficult, and how can these complications be addressed?

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