Severe loss and recovery of vision after glaucoma filtration surgery

To report a case of sudden, severe, unexplained, bilateral loss of vision after glaucoma filtration surgery in both eyes; the vision returned 2 months later.

The clinical records of the patient were reviewed retrospectively. Observations were made and collated as the case progressed.

A 25-year-old man previously diagnosed with poorly controlled, far-advanced, juvenile-onset primary open-angle glaucoma underwent bilateral guarded filtration procedures. Preoperative visual acuity was 20/40 in the right eye and 20/100 in the left eye. After the procedure visual acuity was severely diminished to no light perception in the right eye and light perception in the left eye. There was no apparent cause for the visual reduction other than the decrease in intraocular pressure caused by the surgery. Two months postoperatively, the patient had visual acuity of 20/80 in the right eye and 20/200 in the left eye. Ten months postoperatively, visual acuity was 20/70 in the right eye and 20/200 in the left eye. Twenty-three months postoperatively, visual acuity was 20/100 in the right eye and 20/200 in the left eye.

This case provides evidence for the potential reversibility of severe visual loss after glaucoma filtration surgery.