Cases

Case 1 – 2024
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
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
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
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
Previous Assessment
Next Assessment

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

Cases Case 4 – 2024 Question 9: Why would you use Brimonidine tartrate in NAION?

You have seen previous similar patients where the ophthalmologist started them on topical Brimonidine tartrate twice a day in the affected eye.

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

Answer

There is no proven treatment for NAION. However, the use of Brimonidine tartrate in eyes with NAION is based on animal studies suggesting a potential neuroprotective effect on retinal ganglion cells in cases of NAION. The BRAION study did not indicate any harmful effect of Brimonidine in patients suffering from NAION. However, a statistically significant advantage for patients receiving brimonidine tartrate could not be shown.(The BRAION study group, 2006)

Answer ends

 

 

Previous Assessment
Back to Case
Next Assessment

Login