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A 25-month-old girl with vision loss, nystagmus, and anomalous head posture
Digital Journal of Ophthalmology 2009
Volume 15, Number 1
February 23, 2009
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Joel Metzger, MD | Senior Flight Surgeon, Training Air Wing Six, Pensacola, FL, USA
Richard Hertle, MD | Children's Hospital of Pittsburgh, Pittsburgh, PA, UPMC Eye Center, Eye & Ear Institute, Pittsburgh, PA, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
John Avallone, MD | Ophthalmology Associates of Greater Annapolis
Edward Cheeseman, M.D. | University of South Carolina School of Medicine, Charleston, SC and Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Treatment
Over the next 18 months, the patient underwent 360 degrees of unsuccessful trabeculotomy on each eye followed by uncomplicated placement of Baerveldt implants in both eyes and a bilateral medial rectus recession. Throughout the course of these interventions, her vision continued to improve and her exam stabilized. Her IOP 18 months after presentation was 10-12 mmHg OD and 15-17 mmHg OS. The cup-to-disc ratio was 0.4-0.6 OU, and her refraction was –4.00 +1.00 x180 OD and –5.00 +2.00 x180 OS. Visual acuity using HOTV optotypes was 20/70 OU, and the AHP, nystagmus and esotropia were decreased.
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