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Case Example

 

A 60 year old woman presents to you for a routine review.

Past ocular history: Myopia

Past medical history: Migraines, Raynaud's phenomenon

Medications: Aspirin

Family history: Mother had glaucoma

Examination:

 
Right eye
Left eye
VA with glasses
6/6
6/6
IOP
18 mmHg
15 mmHg
Ishihara colour plates
12/13
13/13
Pupils
No RAPD
Gonioscopy
d40r
d40r
Central corneal thickness
493
497

Appearance of the optic nerves:

Figure 1a Figure 1b

Figure 1a/b — Right and left optic nerves

 

Figure 2a

Figure 2a — Right visual field

 

Figure 2b

Figure 2b — Left visual field

 

Figure 3

Figure 3 — RNFL thickness analysis

 

 

 

 

 

 

 

 

 

 

 

References:

  1. Mudumbai RC. Clinical update on normal tension glaucoma. Seminars in Ophthalmology. 2013; 28: p. 173-179. informahealthcare.com/doi/pdf/10.3109/08820538.2013.771202
  2. Drance S, Anderson DR, Schulzer M, for The Collaborative Normal Tension Glaucoma Study Group. Risk factors for progression of visual field abnormalities in normal tension glaucoma. Am J Ophthalmol 2001; 131: 699-708
  3. Anderson, D. R. (2003). Collaborative normal tension glaucoma study. Current opinion in ophthalmology, 14(2), 86-90.

 

Pre-test reading:

  1. Mudumbai RC. Clinical update on normal tension glaucoma. Seminars in Ophthalmology. 2013; 28: p. 173-179. informahealthcare.com/doi/pdf/10.3109/08820538.2013.771202
  2. Anderson, D. R. (2003). Collaborative normal tension glaucoma study. Current opinion in ophthalmology, 14(2), 86-90.

 

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