A 41-year-old healthy man with an ocular history of myopia and a family
history of glaucoma was seen for complaints of decreased visual acuity for
several months. After instillation of a fluorescein sodium–benoxinate
hydrochloride solution, the applanation tonometry demonstrated the intraocular
pressure (IOP) of 21 mm Hg OU, and immediately after tonometry, the patient
fainted. Owing to lightheadedness, he refused additional drops for dilation.
The undilated fundus examination revealed a cup-disc ratio of 0.50 U. The
patient was followed as a glaucoma suspect, and after each IOP measurement,
he felt faint, sweaty, or lightheaded. On one occasion, he experienced a severe
VVR, became lightheaded, tremulous, diaphoretic, and fainted. Blood pressure
and pulse were measured immediately following this presumed VVR and were found
to be normal, 134/84 mm Hg and 74 bpm, respectively. No formal testing for
VVR was performed.