A 23-year-old man presented with vernal keratoconjunctivitis with steroid-induced glaucoma in both eyes. Intraocular pressure was right eye (OD) 40 mmHg, left eye (OS) 42 mmHg. Significant optic nerve head (ONH) cupping was noted in both eyes (A, OD; B, OS). Topical steroids were immediately stopped and the patient was started on maximum topical antiglaucoma medications with oral acetazolamide and syrup glycerol. Intraocular pressure was controlled on the fourth day of treatment (OD 16 mmHg, OS 18 mmHg) with drastic reversal of ONH cupping (C, OD; D, OS). Unlike children, reversal of ONH cupping is rare in adults due to the reduced pliability and elasticity of lamina cribrosa. These images highlight that although acute intraocular pressure rise can lead to mechanical compression of axons at lamina cribrosa, aggressive control of intraocular pressure and elimination of the primary cause can reverse ONH cupping even in young adults.
From “Rapid Reversal of Optic Nerve Cupping in Steroid-Induced Glaucoma” by Manasi Tripathi, MD, FRCS, Vinit Tanwar, MD, Varun Gogia, MD. Published by Ophthalmology Glaucoma online on April 14, 2025.
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@iDrSunny@fhussain73@DrRichardPile Well even more so, pt outcomes are exactly what matter most. The highest standards of care means recognising the unique training doctors receive. Allied professionals play a role, but patient safety requires clarity in scope and expertise. Collaboration, not confusion.
@fhussain73@iDrSunny@DrRichardPile An incredibly poor point to make. This is not remotely comparable to the fight that women had to study medicine. Respecting the value of allied health professionals doesn’t mean you should overlook key differences in training & expertise.
We flew over Hurricane Milton about 90 minutes ago. Here is the view out the Dragon Endeavour window. Expect lots of images from this window as this is where I’m sleeping while we wait to undock and return to Earth.
Timelapse coming in a separate post.
1/6400 sec, f8, ISO 500
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