Managing VMT with advanced glaucoma

Patient with VMT and advanced glaucoma in her only eye presented initial BCVA of 20/20, which declined to 20/50 over months due to worsening traction. A tailored PPV was performed, undermining the vitreous around the fovea before inducing PVD. Due to advanced glaucoma, ILM peeling was avoided to preserve the nerve fiber layer. Postoperative OCT showed early anatomical improvement despite air tamponade. The case highlights a cautious approach balancing traction relief and neuroprotection.