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Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.
On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.
A dilated fundus examination was performed demonstrating the following:
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Glaucoma
Case 4
Patient Presentation: A 73-year-old female was referred from her optometrist after a dilated fundus examination demonstrated optic disc cupping bilaterally (OD > OS). Her visual acuity was 20/20 OD and 20/30 OS. IOP was 28 OD and 16 OS. Her angles were open bilaterally on gonioscopy. ONH/RNFL OCT and GCC OCT analyses were completed and shown below:
Question: What abnormalities seen on ONH/RNFL OCT in the right eye?
Question: Based on the patient’s OCT images, what visual field defect would you expect to see?
Question: What stage glaucoma does the patient have in the right eye?
Learning Objectives:
1. Interpreting RNFL and GCC OCT images in patients with severe glaucoma.
2. Staging glaucoma severity using HAP Criteria and central involvement.
3. Correlating OCT deficits with visual field changes.
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