Case 5: Physical Exam

Case 5 Index

Answer: Chronic open angle glaucoma should be at the top of the differential, as all the drops shown by the patient are used in the treatment of glaucoma. Acute angle closure glaucoma is less likely given that it is typically characterized by sudden onset blurred vision and and eye pain.

Here’s the physical exam:

Physical Exam

VA with correction: right eye 20/50, left eye 20/60
EOM: full
Confrontation Visual Fields (CVF): restricted 360 on both sides
Pupils: PERLLA

External Exam: lids within normal limits, conjunctiva with tr injection bilaterally, cornea clear, anterior chamber formed, iris flat bilaterally

Intraocular Pressures: On palpation the eyes do not feel firm

On fundoscopic exam with the panoptic you see this:

both ONs glaucoma

You arrange for the patient to follow up with his ophthalmologist in the next few weeks.

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Case 5 Index
Case 5: Introduction