Page 54 - 21st Century Perspective - Glaucoma Supplement

Here is how the case played out: Two and a half years later, the patient noticed a loss of vision in his
left eye, and presented to another eye care provider’s office, where he was found to have increased
IOP into the low 30s mm Hg. He was also found to have a C/D ratio of 0.8 in the left eye (yet he still

had a C/D ratio of 0.2 in the right eye). He had lost the inferior half of his visual field in his left eye.
Obviously, the patient’s glaucoma had progressed far more rapidly than was typical. He was thought
to have plateau iris syndrome, which may have accounted for the rapid progression of the disease
state.

This patient will suffer permanent vision loss by his own negligence — that is, his failure to follow up
in a timely manner — and the optometrist’s negligence to explain to the patient the vital importance
of the attentive follow-up care. Such scenarios ​(Figure 28)​ are fully preventable and require only
basic, prudent follow-up of any findings out of the norm such as asymmetric IOP.

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