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A 15-year-old boy presented with a complaint of “chronic progressive loss of vision”. He complained that vision in the right eye had been a problem for three months and in the left eye for one month. At a school screening eye examination a year before he recalls being told he had 6/6 vision in both eyes. He complained of “red and teary” eyes and produced a bottle of eye drops that he had been using for four months. They were prescribed by an ophthalmologist for eye allergy. The ophthalmologist asked him to return after using the drops three times a day in each eye for two weeks. However, the boy did not return for the follow up visit because his eyes were feeling a little better. When the original supply of drops ran out he was able to get more on his own and has continued to use them regularly up to the present. Visual acuity was right eye hand motions and left eye 6/12. Examination of the retina is as shown in the pictures above. Intraocular pressure was right eye 44 mm Hg and left eye 42 mm Hg.

1.	The most striking feature of the fundus examination is:
	a. subtle maculopathy b. that it is normal c. minimal drusen d. optic atrophy in both eyes e. none of the above
2.	The most likely diagnosis is:
	a. early onset chronic simple glaucoma b. steroid induced glaucoma c. not clear d. allergic glaucoma e. none of the above
3.	This boy should be treated with:
	a. stopping the drops b. starting medicine to reduce the pressure c. surgery if the pressure is not controlled by other means d. reducing the dose of the drops or finding a substitute if the original is serious and persists e. all of the above

For answers to the above, click here on or after July 20, 2010.