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Case Report
An unusual case with a challenging combination of glaucoma, keratoconus, and ocular surface disease
1 FRCO FRCOphth, Specialty Doctor in Ophthalmology, Ophthalmology Department, Glangwili General Hospital, Carmarthen, Carmarthenshire, UK
2 BSc(Hons) MCOptom, PGCert, Prof Cert Glauc, Prof Cert Med Ret, Prof Cert Paed Eyecare, Specialist Optometrist, Ophthalmology Department, Glangwili General Hospital, Carmarthen, Carmarthenshire, UK
Address correspondence to:
Nicky Jones
Specialist Optometrist, Ophthalmology Department, Glangwili General Hospital, Dolgwilli Road, Carmarthen, Carmarthenshire SA31 2AF,
UK
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Article ID: 100006O02GS2022
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Sreekanth G, Jones N. An unusual case with a challenging combination of glaucoma, keratoconus, and ocular surface disease. Edorium J Ophthalmol 2022;5(2):1–4.ABSTRACT
A 64-year-old gentleman presented for the first time with severe pain, redness, and blurred vision in his left eye with examination revealing corneal hydrops. Discussion with the patient revealed a complex history of bilateral keratoconus and glaucoma. He also had chronic kidney disease, diabetes, Parkinson’s, and mental health conditions. Management of the patient involved a delicate balance between building enough trust to allow examination of the anxious patient without pushing too hard that he would not come back for treatment. Treatment was further complicated when he developed Herpes Simplex Keratitis and a rise in his intraocular pressures. The patient was not comfortable being in a hospital environment as he felt that he would “catch something,” he would also refuse some examinations and tests. However, with a gentle approach and support from occupational therapy and community nursing teams, a way forward was found that enabled him to remain living independently.
Keywords: Anterior surface disease, Anxiety, Glaucoma
SUPPORTING INFORMATION
Acknowledgments
Thank you to the nursing and technician staff involved with seeing this patient.
Author ContributionsGayathri Sreekanth - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Nicky Jones - Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Gayathri Sreekanth et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
