Clinical Summary

A 40-year-old white man had undergone trabeculectomy with mitomycin C in his left eye two years earlier. On examination, the intraocular pressure in this eve was 11 mm Hg and had been stable since the surgery. Visual acuity was 20/20. Anterior segment examination was unremarkable. Dilated fundus examination (A,B) revealed marked cupping with loss of the neuroretinal rim between 1:00 and 6:00. An intermediate superior nasal step and an earlier inferior nasal step were identified on the f Humphrey visual field (D).

Optical Coherence Tomography

A 3.4 mm diameter circular OCT (E) revealed significant thinning of the nerve fiber layer, greater inferior! v than superiorly, consistent with the visual field defect.

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