Case 2 – 2024

Learning Outcomes

  • To recognise the features of manifest primary open angle glaucoma,
  • To understand the basic and advanced principles of Visual field testing.
  • To understand and interpret OCT in the context of glaucoma
  • To understand the artifacts associated with visual field and OCT

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Case:

A 59 year-old Caucasian woman presented for a routine optometry examination. She is emmetropic but has developed presbyopia. She has been wearing over-the-counter readers until now.

She is not aware of a family history for glaucoma. She reports good general health, and mentioned that he takes Lipitor for high cholesterol, and that this is now well-controlled with medication.

Clinical examination:

Right Eye Left Eye
VA 6/5 unaided 6/15 unaided, 6/6 with pinhole
Pupils Small L RAPD
Colour Vision 15/15 15/15
IOP 16 mmHg 20 mmHg
Gonioscopy C-D30r C-D30r

Optic nerve photos

Visual Fields

Optical Coherence Tomograph

Optical Coherence Tomography – Ganglion Cell Complex

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