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:
VA with correction: right eye 20/50, left eye 20/60
Confrontation Visual Fields (CVF): restricted 360 on both sides
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:
You arrange for the patient to follow up with his ophthalmologist in the next few weeks.
Click here for more information from the ophthalmology appointment!
Case 5 Index
Case 5: Introduction