Clinical Practice Today: Managing Juvenile Open Angle Glaucoma

Clinical Practice Today is a monthly newsletter from Duke Health

Quick Case Challenge

Spanning a 15-year period, a woman tried numerous medical interventions to manage her juvenile, open-angle glaucoma. Her ophthalmologist, Leon Herndon, MD, chief of the glaucoma division at the Duke Eye Center, first prescribed glaucoma drops. After several years, the drops failed to control her intraocular pressure (IOP), and she elected to undergo surgery.

Herndon then performed glaucoma tube-shunt surgery in both eyes. However, the tubes eroded through her protective tissues, making her eyes susceptible to infection, and he removed the tubes. Next, he tried trabeculectomy, which successfully controlled her IOP in her left eye, but the IOP in her right eye remained high (~ 30 mm Hg). By the time she was 33 years old, she demonstrated progressive loss of peripheral vision in her right eye.

Question: What new surgical option did Herndon perform to treat the patient’s glaucoma?

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