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2005 Series - April 5, 2005
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Lecture 39 of 52 NEXT»
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A 42-year-old Hispanic female with no significant past medical history or past history for ocular disease presents with complaint of mild right sided headache (HA) and blurred vision OD. The patient reports that the headache and blurred vision occurred at the same time beginning 3 days ago. This patient denies ocular pain, photophobia, nausea, floaters, photopsias, and halos around lights. Visual acuity without glasses is OD 20/200 ph 20/80 and OS 20/30-1 ph 20/25.
The pupils are 4 - 3 mm with no relative afferent pupillary defect. Confrontational visual fields are full to counting fingers OU. Motility is full OU. Applanation pressures were OD 56, OS 24. Slit lamp examination shows 3+ conjunctival injection OD and trace cell and flare in the right eye. The anterior chamber appears to be deep in both eyes. Dilated fundus examination reveals OD: cup to disc ratio (CDR) 0.7, healthy rim, no notching, no hemorrhage, otherwise within normal limits; OS: CDR 0.5, healthy rim, otherwise within normal limits.
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| 1. |
What is the most likely diagnosis? |
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| a. |
ocular pseudotumor |
| b. |
primary open angle glaucoma |
| c. |
acute angle closure glaucoma |
| d. |
Posner-Schlossman syndrome (glaucomatocyclitic crisis) |
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| 2. |
What is the next best step for this patient? |
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| a. |
observation |
| b. |
peripheral laser iridotomy |
| c. |
topical and/or oral antiglaucoma medications |
| d. |
trabeculectomy |
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| 3. |
What is the best step to avoid further attacks? |
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| a. |
long term Pilocarpin administration |
| b. |
long term topical steroid administration |
| c. |
glaucoma surgery |
| d. |
none of the above | |
For answers to the above, click here on or after April 12, 2005.
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