A 40-year-old Asian gentleman with pathological myopia, bilateral retinal detachment surgery (both scleral buckle and vitrectomy) was referred to Ophthalmic Surgeon- Gurjeet Jutley by another consultant with the following clinical picture:

  • Axial length of 30 mm
  • Pressure of 30mmHg on quadruple drop therapy and maximal oral acetazolamide
  • Cup-disc-ratio of 0.9 with advanced visual field defects

The consideration of the high myopia, previous retinal surgery and advanced glaucoma gave a difficult management decision:

  • Leaving on medical treatment could lead to kidney problems
  • Cyclodiode laser
  • Tube surgery, with risk of choroidal effusion (fluid in the deeper layer of the eyes) and manipulating thin sclera


  • We decided a tube surgery: two weeks after the operation:
    • Unaided vision 6/9
    • Pressure of 10 off treatment
  • The right eye will be addressed shortly