The patient, a 67 y/o female retired librarian, has not had an eye exam in 12 years
The patient, a 67 y/o female retired librarian, has not had an eye exam in 12 years
In the clinic she states no problems with driving short distances, reading or using the computer. She uses OTC readers for close work. She states mild eye burning especially after reading for long time. No
floaters or halos, pain, double visions or redness.
PMH/PSH- hypertension x 10 years; controlled; CS x 1
Meds: hydrochorothiazide
Allergies: NKDA
Ocular Hx- presbyopia, no eye surgeries, hx of eye trauma.
Ocular Family Hx- mother and father cataracts; neg- macular degeneration
ROS- denies any recent illness or any new CV, Resp, GI, CNS, Skin or musculoskeletal sx
Ocular Exam
Visual acuity OD (Right) 20/20 OS (Left) 20/20
IOP (PRESSURE) OD 21mm Hg OS 23 mmHg
Pupil- Equal, round and reactive to light (PERRL), no APD ( afferent pupillary defect)
Automated visual field test: superior arcuate defect in both eyes
No nastigmus
Questions:
1.What do you think this patient has?
2. What are the Differential Diagnosis?
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