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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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Paediatric Ophthalmology
Case 3
Patient Presentation: An 11-year-old boy was referred to a pediatric ophthalmology clinic from his optometrist for concern of bilateral optic nerve head swelling. The patient went to his optometrist for routine examination and a glasses update; he was asymptomatic with no headaches or visual changes. The patient denied past medical or ocular history. Best corrected distance visual acuity was 20/20 OD and 20/20-2 OS; IOP was 14 OD and 12 OS. There was no RAPD. Colour fundus photographs and OCT line scans of the optic nerves were taken and are shown below:
Question 1: What main finding is seen in the OCT images above?
Question 2: What is the most likely diagnosis?
Question 3: What other imaging modalities can be used to confirm the diagnosis of optic disc drusen?
Question 4: What is the most common visual field deficit seen with ODD?
Learning Objectives:
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Understand the signs of optic disc drusen on OCT and multimodal imaging.
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Differentiate optic disc drusen from papilledema.
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