case_images: PMC11052560_01
case_images: Humphrey 24-2 VF testing of both eyes, showing early superonasal VF loss in both eyes across three examinations.
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case_images: PMC11052560_01_cop-2024-0015-0001-538547_F01.jpg
case_images: F1
case_images: VF testing with computerized automated perimetry (Humphrey 24-2 threshold white-on-white test, using the SITA-Fast algorithm with a size III stimulus) showed early superonasal VF loss in both eyes (right eye had a mean deviation of -2.92 dB with borderline glaucoma hemifield test, while the LE had a mean deviation of -2.78 dB with abnormal glaucoma hemifield test), with low test reliability of the LE due to high percentage of fixation loses (shown in Fig. 1). During the next visits (seven and 10 months after her first appointment) IOP was well controlled, while no changes were noted in the VF testing, optic nerve examination and pigment dispersion (shown in Fig. 1).
case_images: Infrared imaging and retinal nerve fiber layer (RNFL) thickness analysis, showing highly tilted optic discs with peripapillary atrophy in both eyes and borderline RNFL decrease in the LE.
case_images: cop-2024-0015-0001-538547_F02.jpg
case_images: PMC11052560_01_cop-2024-0015-0001-538547_F02.jpg
case_images: F2
case_images: Retinal nerve fiber layer thickness measured by optical coherence tomography (Spectralis  OCT, Heidelberg Engineering, Heidelberg, Germany) was borderline decreased in the inferotemporal segment of the LE (shown in Fig. 2). Fundoscopy also revealed signs consistent with high myopia like tilted optic discs with peripapillary atrophy (shown in Fig. 2) without any glaucomatous optic nerve damage.
case_images: Slit-lamp photography of the right eye (a) and LE (b), showing iris transillumination defects and the edge of the ICLs seen through the surgical iridectomy sites. Pigment deposition on the anterior surface of the ICL in the right eye (c) and LE (d) can also be seen.
case_images: cop-2024-0015-0001-538547_F03.jpg
case_images: PMC11052560_01_cop-2024-0015-0001-538547_F03.jpg
case_images: F3
case_images: Slit-lamp biomicroscopy showed in both eyes pigment deposition on the corneal endothelium and on the anterior surface of the ICL, patent superior iridectomies, iris transillumination defects and iris vaulting at the areas of contact with the ICL (shown in Fig. 3, 4).
case_images: Slit-lamp photography of the right eye (a) and LE (b), showing pigment deposition on the corneal endothelium on the anterior surface of the ICL. Grade 4+ pigmentation (black arrows) of the trabecular meshwork and iris forward vaulting at the areas of contact with the ICL (white arrows) seen in gonioscopy of the right eye (c) and LE (d).
case_images: cop-2024-0015-0001-538547_F04.jpg
case_images: PMC11052560_01_cop-2024-0015-0001-538547_F04.jpg
case_images: F4
case_images: Slit-lamp biomicroscopy showed in both eyes pigment deposition on the corneal endothelium and on the anterior surface of the ICL, patent superior iridectomies, iris transillumination defects and iris vaulting at the areas of contact with the ICL (shown in Fig. 3, 4). Additionally, gonioscopy showed open angles bilaterally with grade 4+ pigmentation of the trabecular meshwork (shown in Fig. 4).