With a focus on diagnosis of eye disease, particularly glaucoma, the following clinical images demonstrate the importance of performing appropriate functional testing when it is clinically indicated in structural assessment.
Case supplied by Kevin Middleton, Specsavers Cranbourne, VIC
Px: 61-year-old female
IOPs: RE 11 mmHg and LE 11mmHg
No remarkable presenting signs or symptoms.
OCT widefield reports:
Consider the structural information provided in the OCT scans above:
- What’s normal?
- What’s abnormal?
- Are there any clinical indications for functional testing?
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The OCT widefield reports contain the following clinical indicators for functional testing:
- Indistinct disc margins OU
- Superior RNFL defect OU.
Functional testing was conducted and the visual field results are shown below.
Visual field results:
The visual field results show an inferior defect in both eyes, with the RE almost completely respecting the horizontal midline and being more severe and quite significant.
- Optic atrophy
- Compressive optic neuropathies
- AION / NAION
- Normal-tension glaucoma (advanced)
This patient was referred with some urgency to ophthalmology, with additional patient follow-up to stress the importance of attending for further consultation.