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Glaucoma Masked by Systemic Medications

Orna Geyer, MD; Anat Loewenstein, MD; Moshe Lazar, MD
Arch Intern Med. 1991;151(6):1236. doi:10.1001/archinte.1991.00400060142032.
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To the Editor.—  Open angle glaucoma is a common disease, occurring in about 2% of the population above 40 years of age. We occasionally see patients who suffer from glaucoma and in whom the disease is "masked" by systemic medications. We report two of these cases.

Report of Cases.—CASE 1.—  A 50-year-old man suffered from glaucoma and was treated with pilocarpine eye drops for 2 years. In 1987, his intraocular pressure was found to be low repeatedly, and the pilocarpine treatment was discontinued. Numerous examinations showed that the intraocular pressure stayed normal. The patient was informed that glaucoma was misdiagnosed, and frequent opthalmological follow-up examinations were stopped. In 1990, the patient was found to have high intraocular pressure (34 mm Hg) in both eyes, glaucomatous excavation of his optic discs, and a visual field defect. Questioning revealed that the patient suffered from hypertension and was treated by


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