OPTOMETRIC EDUCATION CONSULTANTS CLINICAL CASE CHALLENGE
Case Challenge 16 – July 2024
A 46-year-old woman presents for new onset vision loss in her right eye for the past month. She has no pain or diplopia and feels that her vision has been stable since. Her medical history is unremarkable and felt that she might have had COVID one week before vision loss, but did not test for the virus. Her best corrected visual acuity is 20/60 OD and 20/20 OS with a relative afferent pupil defect OD. Her dilated exam reveals normal optic discs with cupping at 0.6/0.6 OD, OS. Optical coherence tomography (OCT) reveals a normal retinal nerve fiber layer and ganglion cell complex OU. Threshold perimetry is normal in her left eye and there is an inferior arcuate defect in her right eye.
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Click on the toggles below to read previous case challenges.Case Challenge 15 – March 2021
Left ptosis and miosis Neck incision following parathyroid surgery A 73-year-old woman presented urgently with a sudden left ptosis. She noticed it immediately after undergoing parathyroid surgery to remove 3 adenomas the day...
Case Challenge 14 – February 2020
An 82 year old man presented complaining of a moderately painful left eye of approximately 2-week duration. He was both diabetic and hypertensive. He was 20/25 OD and bare light perception OS. His intraocular pressure (IOP) was 23 mm Hg OD and...
Case Challenge 13 – November 2019
A case of very high pressure A 21-year-old woman was referred for assessment of elevated intraocular pressure (IOP). She did not recall the IOP level, nor did she bring any referral form from her previous doctor. She presented in no acute...
Case Challenge 12 – September 2019
A 37-year-old woman presented for a glaucoma evaluation and ongoing care. She had previously been diagnosed with glaucoma approximately 3 years earlier and was using bimatoprost 0.01% OU QHS. She had not had any care for the past year. Her visual acuity...
Case Challenge 11 – July 2019
A 57 year old asymptomatic woman was referred for a glaucoma evaluation due to elevated intraocular pressure (IOP). Her visual acuity was 20/20 in each eye and pupils were normal without afferent defect. Her IOP was 25 mm Hg OD and 24 mm Hg OS. Her optic...
Case Challenge 10 – May 2019
A 46-year-old woman presented for a scheduled IOP check and visual field as a glaucoma suspect. She had a history of breast cancer 5 years earlier and was using tamoxifen. She reported that she got some cleaning fluid in her right eye 4 weeks earlier. She...
Case Challenge 09 – April 2019
An 84-year-old African-American man with a history of glaucoma presented for consultation and care. Review of past records indicated that he had also been diagnosed the previous year with dry age-related macular degeneration (AMD) OD and wet AMD...
Case Challenge 08 – March 2019
A 53 year old man who had been treated for advanced glaucoma presented with slowly progressive, painless vision loss in his right eye. He had missed his visits for the past year, though he had been obtaining medication refills through his pharmacy. His...
Case Challenge 07 – January 2019
A 25 year old woman was involved in a minor automobile accident where she was hit by another driver. The accident was reportedly minor, with no initial injury to either driver, and both cars were able to be driven away. She felt that she experienced only a...
Case Challenge 06 – November 2018
Optometric Education Consultants Clinical Case Challenge A 21 year old male plumber called in requesting an urgent appointment. He was working on a job and trying to dislodge a drain coupling by hammering it with the blunt end of a screw driver. He missed,...