Cases | Glaucoma Professional Education Programme

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Case 1 – 2024

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Question 1: Describe the clinical photographs seen in Figure 1.

Question 2: Based on the initial history and examination, what is your working diagnosis?

Question 3: Describe the above optic nerve head photos

Question 4: Describe this patient’s visual field tests.

Question 5: Describe this patient’s RNFL OCT scans and Ganglion cell layer scan

Question 6: What is the difference between pigment dispersion syndrome, pigmentary ocular hypertension (POHT), and pigmentary glaucoma?

Question 7: What is the natural history of pigment dispersion syndrome?

Question 8: What other conditions are associated with anterior segment pigment deposition?

Question 9: What is the role of laser peripheral iridotomy in the treatment of patients with pigment dispersion syndrome or pigmentary glaucoma?

Question 10: How is elevated IOP managed in pigmentary glaucoma?

Required Reading & References

Case 2 – 2024

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Question 1: Describe the patients optic nerve

Question 2 : Describe this visual field and what each letter refers for the letters A-E:

Question 3 : Describe this visual field and what each letter refers for the letters F-J:

Question 4: Describe the difference between the points tested for in 24-2 and 10-2 visual field test.

Question 5. Describe what are false positives and how it is deternined by automated visual field testing.

Question 6: What are false negatives and what are features on a visual field which suggest the defect is caused by false negatives?

Question 7: How are fixation losses determined and what is the most common reason for high fixation losses?

Question 8: What is the Hodapp-Anderson-Parrish criteria for Minimum Criteria for Diagnosing Acquired Glaucomatous Damage in a 24-2 Examination

Question 9: What features would suggest conversion from being a Glaucoma Suspect to Manifest Glaucoma?

Question 10: What features would suggest a non-glaucomatous optic neuropathy rather than glaucoma?

Required Reading & References

Case 3 – 2024

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Question 1:Describe the colour fundus photographs in Figure 1.

Question 2: What is your assessment of the visual fields?

Question 3: Describe the patient’s OCT retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) analysis

Question 4: What is your working diagnosis?

Question 6: Why do patients with NVG and a high IOP (e.g. IOP > 40 mmHg) not complain of pain?

Question 5: Describe the Figure 1

Question 7: What are the three most common causes of neovascular glaucoma?

Question 8: What should be done to manage the high IOP in patients with NVG?

Question 9: What other treatment is indicated?

Required Reading & References

Case 4 – 2024

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Question 1: How do you distinguish a true disc pallor from a glaucomatous disc appearance?

Question 2: What is your assessment of the visual fields?

Question 3: Describe the patient’s OCT retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) analysis

Question 4: What is the likely diagnosis?

Question 5: Discuss the pathophysiology of NAION, including the risk factors.

Question 6: Discuss the management options for NAION.

Question 7: Describe the patient’s OCT retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) analysis

Question 8: Is the patient’s fellow unaffected eye at risk of developing NAION? Why or why not?

Question 9: Why would you use Brimonidine tartrate in NAION?

Question 10: What is the relevance of taking sildenafil in this case?

Required Reading & References

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