Glaucoma in the Elderly

An 85-year-old Latin American female presents for evaluation after an increased intraocular pressure was detected at a community screening for glaucoma. She has a past medical history of severe degenerative arthritis in her hands and suffers from stable angina. Though widowed, she lives independently near her family; she has declined previous suggestions to move in with them or to the local retirement center. On examination the patient has 20/20 visual acuity OU, an increased intraocular pressure (IOP) of 28 mmHg OU, glaucomatous cupping of 0.6 OU, and a superior arcuate glaucomatous defect OU. At that point, her eye doctor begins a one-eyed trial in the right eye (OD) of timolol GFS 0.5% each morning.