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March 1997

Pseudotumor Cerebri Appearing With Unilateral Papilledema After Trabeculectomy

Author Affiliations

New York, NY

Arch Ophthalmol. 1997;115(3):423-426. doi:10.1001/archopht.1997.01100150425022

We describe a patient with papilledema due to pseudotumor cerebri that was seen unilaterally following normalization of intraocular pressure (IOP) and discontinuation of systemic acetazolamide therapy following trabeculectomy. We hypothesize that the lamina cribrosa sclerae serves as a flexible barrier between intracranial pressure (ICP) and IOP and that alterations of the normal ICP/IOP ratio may lead to papilledema. To our knowledge, there have been no reports describing the development of unilateral papilledema following surgical reduction in IOP.

Report of a Case.  A 41-year-old obese white woman with a 9-year history of juvenile primary open-angle glaucoma underwent uncomplicated trabeculectomy in the left eye with supplemental 5-mg subconjunctival injections of 5-fluorouracil (50 mg/mL) because of progressive glaucomatous cupping. Preoperative IOP was 23 mm Hg in the right eye and 35 mm Hg in the left eye while receiving acetazolamide sequels, 500 mg twice daily, plus a combination of timolol maleate 0.5% and

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