Abstract
<h4>The Case</h4> <p>A 6-month-old infant presented for evaluation of anisocoria. At 1 month of age, a left nasolacrimal duct obstruction (NLDO) was recognized. Treatment with TobraDex ointment (Alcon, Fort Worth, TX) twice daily was started and continued until 5 months of age, when enlargement of the left cornea was noticed (Figure). Successful NLDO probing was then performed, and examination with anesthesia revealed an enlarged eye, anisocoria, intraocular pressure (IOP) of 30 mm Hg, and optic disc cupping on the left. A 2-month trial of medical glaucoma therapy failed, and a goniotomy was advised (S. Salim, MD, and D. S. Walton, MD, unpublished data, 2005). At 20 months after goniotomy, the IOP is well controlled without medication.</p>
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