Clinical Intake — Primary open-angle glaucoma

A 68-year-old female presents with a 33-month history of primary open-angle glaucoma of the right eye, initially detected on routine ophthalmologic examination with elevated intraocular pressure and an increased cup-to-disc ratio. Despite over two years of first-line topical prostaglandin analog therapy with good adherence, intraocular pressure remains above the target range at 22 mmHg, and structural evaluation reveals mild inferior rim thinning with borderline nerve fiber layer thinning on imaging. Concurrent progressive lens opacity in the right eye has reduced best-corrected visual acuity to 20/50, causing functional visual impairment. Her ophthalmologist notes that conservative medical management has yielded only partial pressure reduction and recommends further surgical evaluation to address both the pressure control and the visually significant lens changes.