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Case 12-22, Glaucomatous Progression

Clinical Summary

A 74-year-old man with primary open angle glaucoma was using timolol 0.5% twice daily. Visual acuity was 20/ 20 bilaterally, and intraocular pressures were 24 mm Hg in each eye. Slit-lamp examination was unremarkable, and both angles were open 360° to the ciliary body band. There was moderate cupping of the optic discs in both eyes with intact neuroretinal rims, both of which were slightly thinned inferotemporally (A,F), Humphrey visual fields showed early superior nasal steps, worse on the left (H) than the right (C)+

One year later, there was an increase in the size of the visual field defect bilaterally (H,C), with a minimal increase in cupping (B,G),

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