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 David Jones, Specsavers Mt Ommaney, QLD
Px: 28-year-old female
IOPs: RE 15mmHg and LE 17mmHg
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:
- Superior and inferior thinning of the RNFL OU
- Vertical CD ratio is outside normative limits in LE.
Functional testing was conducted and the visual field results are shown below.
Visual field results:
The visual field results show a left localised infero-nasal step outside normal limits. The probability of the visual field being normal is less than 1%. A milder right superior field loss can also be seen, with the probability of deviation being normal under 5%.
The patient was referred to public ophthalmology and triaged under their guidelines.