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Systemic diseases blurring diagnosis? Is glaucoma appearance due to tamoxifen, or to thyroid disease? Or maybe neither?(Glaucoma Grand Rounds)
A 63-year-old white female presented in the fall of 1998 for a routine primary eye care visit. She was taking Vaseretic (enalapril/hydrochlorothiazide, Merck), Synthroid (levothyroxine sodium, Abbott), and 20mg Nolvadex (tamoxifen, AstraZeneca) qd. She had a 10-year history of hypertension, and had abnormal thyroid studies for more than 20 years.
She also had breast cancer. About nine months before initial presentation, she underwent a complete right mastectomy followed by radiation therapy. She started on tamoxifen about four months prior to her initial presentation to me.
[ILLUSTRATION OMITTED]
Her chief complaint at that time was decreased vision at distance and near, which had become more noticeable since her mastectomy. In her family history, she reported that her mother has glaucoma.
Diagnostic Data
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