A 65-Year-Old Man Is Found to Have an Abnormal Reading

A 65-year-old man is found to have an abnormal reading during screening tonometry.  The patient has no visual symptoms or headache.  Medical history is significant for asthma, for which he takes inhaled fluticasone/salmeterol routinely and inhaled albuterol on most days to control the symptoms.  Vital signs are within normal limits.  Eye examination shows normal conjunctivae, corneas, and lenses.  Intraocular pressure is 28 mm Hg (normal: 8-21) .  Funduscopy reveals thinning of the optic disc rim and asymmetry of the cup/disc ratio between the eyes.  Which of the following is the most appropriate next step in management of this patient's ocular condition?

A) Advise to stop glucocorticoid therapy
B) Begin atropine eye drops
C) Prescribe oral acetazolamide therapy
D) Recommend treatment only if symptomatic
E) Start latanoprost ophthalmic solution

Correct Answer:

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