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What Is Causing Progressive Vision Problems in a 32-Year-Old Woman?

— A glaucoma diagnosis at a young age should prompt timely genetic testing

MedpageToday
A photo of a female optometrist examining the left eye of a female patient.

What's behind the progressive lens dislocation that has affected this 32-year-old woman for the past 16 years?

The patient, who was African American, presented with significant vision loss in her left eye, reported Rachel W. Kuchtey, MD, PhD, of Vanderbilt Eye Institute in Nashville, Tennessee, and colleagues in .

The patient's long history of vision problems began when she was diagnosed with glaucoma and elevated intraocular pressure (IOP) at age 13. Her medical history included a bilateral trabeculectomy at the time of her original diagnosis.

About 4 years later, at the age of 17, the patient developed significantly elevated IOP in both eyes, along with severe cupping and open iridocorneal angle in both eyes. Examination showed no signs of Haab striae, buphthalmos, or high iris insertion that would suggest that the patient had primary congenital glaucoma (PCG). Ultimately, both the patient's eyes required glaucoma tube shunt implantation.