Pseudo-reversal of optic disc cupping in a case of pseudo-exfoliation glaucoma following trabeculectomy

Abstract

Reversal of glaucomatous cupping is rare in adults. A case of pseudo-reversal of total cupping in an elderly gentleman with pseudo-exfoliation glaucoma who underwent combined trabeculectomy with cataract surgery is reported. Early laser suture lysis to control high post-operative intra-ocular pressure (IOP) led to sudden lowering of IOP with subsequent optic disc edema, which manifested as reversal of cupping, albeit temporarily. Eight months later, the visual field was stable, but the macula had developed an epiretinal membrane, probably secondary to hypotony-associated inflammation, thus highlighting the importance of timing the suture lysis and aggressive control of intra-ocular inflammation.